OBJECTIVES To examine if educational status is associated with outcome in patients with Small Cell Lung Cancer (SCLC). The study also investigated differences in patterns of management (lead times and treatment intensity) between educational levels. MATERIAL AND METHODS This nationwide cohort study was based on data from Lung Cancer Data Base Sweden (LCBaSe) generated by record linkages between the Swedish National Lung Cancer Register and several other population-based registers. Educational level was categorized by number of years of schooling: low (≤ 9 years), medium (10-12 years) and high (≥ 13 years). Risk of death expressed as hazard ratios (HR) with 95 % confidence interval (CI) were estimated in multi-variable analyses adjusted for age, sex, disease stage at diagnosis, household size and performance status (PS). Analyses stratified by sex and stage were also performed. RESULTS AND CONCLUSIONS The study population encompassed 4256 patients with an SCLC diagnosis between 2002 and 2011. Higher education was associated with a significantly lower risk of death in univariable and multivariable models. The univariable HR comparing high to low level of education was 0.84 (95 % CI: 0.75-0.93), an estimate that was attenuated following adjustments (HR 0.88; 95 % CI: 0.80-0.98). Compared to men with a low level of education, the risk of death was significantly lower in men with a high education; HR 0.84 (95 % CI: 0.73-0.98). In Limited Disease (LD), the prognosis was significantly better in both men and women with high compared low education (HR 0.76; 95 % CI: 0.58-0.98). In Swedish men with SCLC, and among patients with LD-SCLC, a low level of education was associated with a poorer prognosis compared to patients with high education.

中文翻译：

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小细胞肺癌（SCLC）的教育水平，管理和结局：一项基于人群的队列研究。

目的探讨小细胞肺癌（SCLC）患者的教育状况是否与预后相关。该研究还调查了教育水平之间的管理模式（交货时间和治疗强度）的差异。材料和方法这项全国性队列研究基于瑞典肺癌数据库（LCBaSe）的数据，该数据是由瑞典国家肺癌登记册与其他几项基于人口的登记册之间的记录关联而生成的。按受教育年限对教育程度进行分类：低（≤9岁），中（10-12岁）和高（≥13岁）。在针对年龄，性别，诊断时的疾病阶段，家庭规模和工作状态（PS）进行了调整的多变量分析中，估计了以95％置信区间（CI）的危险比（HR）表示的死亡风险。还按性别和阶段进行了分层分析。结果与结论该研究人群包括2002年至2011年间诊断为SCLC的4256例患者。在单变量和多变量模型中，高等教育与较低的死亡风险相关。高学历与低学历的单变量HR为0.84（95％CI：0.75-0.93），这一估计值在调整后有所减弱（HR 0.88； 95％CI：0.80-0.98）。与受教育程度低的男性相比，受教育程度高的男性的死亡风险要低得多；HR 0.84（95％CI：0.73-0.98）。在受限制疾病（LD）中，受过高等教育和低学历的男性和女性的预后都明显更好（HR 0.76； 95％CI：0.58-0.98）。在患有SCLC的瑞典男性以及LD-SCLC的患者中，