P1.07-044 Educational Level and Management in Small-Cell Lung Cancer (SCLC): A Population-Based Study: Topic: SCLC/Neuroendocrine Tumors in General

In a previous study we reported that educational level is a prognostic factor in SCLC, with females and LD patients with a higher education having a longer survival. In this study we examined possible associations between educational level, lead times and treatment strategies in the same cohort. The study was based on information in LcBaSe, a lung cancer research database generated by record linkages between the Swedish National Lung Cancer Register and several other population-based registers. Educational level was categorized according to number of years of schooling; low(≤ 9 years), middle (10-12 years), high (≥13 years). Stage was classified as limited disease (LD) and extensive disease (ED). Lead times were defined as A) from first radiological sign of a tumor to definite diagnosis and B) from date of referral from primary care to diagnosis. Treatment groups were divided as; chemotherapy (CT), CT+Radiation Therapy (CT+RT), Palliative RT or no oncological therapy. The study population encompassed 4278 patients with a SCLC diagnosis between 2002 and 2011. Median age was 69 years. 988 (23.1 %) patients were diagnosed with LD (low E: 22.9 %, middle E: 23.6%, high E: 26.7 %) and 3187 (74.5 %) with ED (low E: 74.8, middle E: 74.0 %, high E: 73.3%). One fifth of patients had a poor performance score (PS 3-4). The median lead time A was 14 days (IQR 5-32 days) and for lead time B 9 days (IQR 3-21 days). There were no differences in lead times between the educational groups. The proportion of patients receiving CT+RT was approximately 80 % in LD (Low E: 78.5% Middle E: 79.2% High E: 82.4 %) and 5 % in ED (Low E: 4.2%, Middle E: 5.3% High E: 6.8%). The percentage of patients receiving CT was 18 % in LD (Low E: 19.7% Middle E: 18.7 % High E: 15.3%) and 82 % in ED (Low E: 81.2 %, Middle E: 83.9 % High E: 81.4 %). There were no significant differences between educational groups in lead times or management. We conclude that the prognostic impact of educational status in Swedish SCLC patients does not appear to reflect inequalities in access to the healthcare.