Aims:To investigate sociodemographic associations with medicated health conditions, general practitioner (GP) contacts, and computed tomography (CT) scans of the lung, as 12-month precursors of diagnosis of lung cancer at a local stage (cancers localized to the primary site of bronchus and lung).Methods:Cancer Registry data for New South Wales (NSW) adults diagnosed with lung cancer (ICD-10 C33-34) since the Census of August 2016 (n = 6160) were linked at person level with census and other administrative data. These included residents diagnosed with lung cancer from September 2016 to December 2018. Structural equation modelling indicated adjusted measures of associations with lung cancer, including adjusted odds ratios (aORs), in stepped analyses.Results:The first part of the multivariate modelling showed age, major city residence, and other sociodemographic characteristics that were associated with numbers of medicated conditions. The second part showed the numbers of medicated conditions and other sociodemographic characteristics that were associated with the number of GP consultations. The third part of the modelling showed the numbers of GP consultations and other sociodemographic characteristics that were associated with having CT lung scans. Modelling showed that having CT scans and being female were the main predictors of lung cancer diagnosis at a local stage, with aORs of 2.30, 95%CI 2.01–2.63 and 1.39, and 95%CI 1.23–1.58, respectively. The modelling also showed age, GP consultations, residence in a major city, and other sociodemographic characteristics to be associated with having CT scans.Conclusions:The findings of the study indicate the main precursors of lung cancer diagnosis at a local stage after multivariate adjustment. Irrespective of causal significance, results reveal population-wide characteristics for targeting screening for early detection. They demonstrate the potential value of person-level linkage of cancer-registry data with census and other administrative data for this purpose. Our study of linked cancer-registry and census data revealed broad descriptive features of pathways to early diagnosis of relevance to service screening and planning.
目的：探讨社会人口学因素与用药健康状况、全科医生就诊次数及肺部计算机断层扫描（CT）之间的关联，这些因素作为肺癌在局部阶段（癌变局限于支气管和肺原发部位）诊断前12个月的预测指标。 方法：将2016年8月人口普查以来新南威尔士州诊断为肺癌（ICD-10 C33-34）的成人患者癌症登记数据（n=6160）与人口普查及其他行政数据进行个人层面关联。研究对象包括2016年9月至2018年12月期间确诊的肺癌居民。通过结构方程模型进行阶梯式分析，得出与肺癌相关的调整后关联度量指标，包括调整后比值比（aORs）。 结果：多变量模型的第一部分显示年龄、主要城市居住地及其他社会人口学特征与用药疾病数量相关。第二部分显示用药疾病数量及其他社会人口学特征与全科医生就诊次数相关。第三部分显示全科医生就诊次数及其他社会人口学特征与接受肺部CT扫描相关。模型分析表明，接受CT扫描和女性性别是局部阶段肺癌诊断的主要预测因素，调整后比值比分别为2.30（95%CI 2.01–2.63）和1.39（95%CI 1.23–1.58）。模型还显示年龄、全科医生就诊次数、主要城市居住地及其他社会人口学特征与接受CT扫描相关。 结论：本研究通过多变量调整揭示了局部阶段肺癌诊断的主要预测因素。无论因果意义如何，研究结果揭示了针对早期筛查可关注的全人群特征。这证明了将癌症登记数据与人口普查及其他行政数据进行个人层面关联在此研究目的中的潜在价值。通过对关联的癌症登记和人口普查数据的研究，我们揭示了与筛查服务和规划相关的早期诊断路径的广泛描述性特征。
肿瘤(癌症)患者之家