Sociodemographic inequalities in non-small cell lung cancer (NSCLC) novel treatments: a national population-based cohort study

BACKGROUND: Sociodemographic inequalities impact patients with non-small cell lung cancer (NSCLC). Advances in novel therapeutics have increased treatment options; however, for advanced disease, prognosis remains poor and inequalities in care are recognised to exist, requiring further characterisation. This population-based study aimed to describe the associations between markers of sociodemographic characteristics and novel anticancer therapy utilisation for a stage IV NSCLC population in a publicly funded healthcare system. METHODS: A retrospective cohort of 73 640 patients with histologically confirmed stage IV NSCLC between 1 January 2017 and 31 December 2021 was identified from the English national cancer registry and linked to the Systemic Anti-Cancer Therapy database. Multivariable logistic regression evaluated likelihood of novel therapy utilisation across sociodemographic characteristics and for pre-COVID-19 and peri-COVID-19 time periods. RESULTS: Patients resident in the most deprived quintile had the lowest likelihood of novel therapy receipt. Patients ≥70 years old had reduced likelihood of receipt (OR: 0.79, CI 0.73 to 0.86), as did patients recorded as ethnicity 'unknown' (OR: 0.85, CI 0.75 to 0.97). Likelihood of utilisation increased from 2017 to 2019 and decreased in 2020 and 2021. Pre-COVID-19 and peri-COVID-19 analysis identified reduced sociodemographic inequalities from 2020, but variation across therapy subgroups. CONCLUSION: Even in the National Hea...