Introduction: Potential disparities in the diagnosis, treatment, and survival of patients with lung cancer with and without disabilities have rarely been investigated. Methods: We conducted a retrospective cohort study with a data set linking the Korean National Health Service database, disability registration data, and Korean Central Cancer Registry data. A total of 13,591 people with disabilities in whom lung cancer had been diagnosed and 43,809 age‐ and sex‐matched control subjects in whom lung cancer had been diagnosed were included. Results: Unknown stage was more common in people with severe disabilities (13.1% versus 10.3%), especially those with a communication (14.2%) or mental/cognitive disability (15.7%). People with disabilities were less likely to undergo a surgical procedure (adjusted OR [aOR] = 0.82, 95% confidence interval [CI]: 0.77–0.86), chemotherapy (aOR = 0.80, 95% CI: 0.77–0.84), or radiotherapy (aOR = 0.92, 95% CI: 0.88–0.96). This higher likelihood was more evident for people with severe communication impairment (aORs of 0.46 for surgery and 0.64 for chemotherapy) and severe brain/mental impairment (aORs 0.39 for surgery, 0.47 for chemotherapy, and 0.49 for radiotherapy). Patients with disabilities had a slightly higher overall mortality than did people with no disability (adjusted hazard ratio = 1.08, 95% CI: 1.06–1.11), especially in the group with a severe disability (a hazard ratio = 1.20, 95% CI: 1.16–1.24). Conclusions: Patients with lung cancer and disabilities, especially severe ones, underwent less staging work‐up and treatment even though their treatment outcomes were only slightly worse than those of people without a disability. Although some degree of disparity might be attributed to reasonable clinical judgement, unequal clinical care for people with communication and brain/mental disabilities suggests unjustifiable disability‐related barriers that need to be addressed.

中文翻译：

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残疾人肺癌诊治差异

简介：很少有人对有残疾和没有残疾的肺癌患者在诊断、治疗和生存方面的潜在差异进行调查。方法：我们使用连接韩国国家卫生服务数据库、残疾登记数据和韩国中央癌症登记数据的数据集进行了一项回顾性队列研究。共纳入 13,591 名确诊为肺癌的残疾人和 43,809 名年龄和性别匹配的确诊为肺癌的对照组。结果：未知阶段在重度残疾人群中更为常见（13.1% 对 10.3%），尤其是那些有交流（14.2%）或精神/认知障碍（15.7%）的人。残疾人接受外科手术的可能性较小（调整后的 OR [aOR] = 0.82，95% 置信区间 [CI]：0。77–0.86)、化疗 (aOR = 0.80, 95% CI: 0.77–0.84) 或放疗 (aOR = 0.92, 95% CI: 0.88–0.96)。对于患有严重沟通障碍（手术 aOR 为 0.46，化疗为 0.64）和严重脑/精神障碍（手术 aOR 为 0.39，化疗为 0.47，放疗为 0.49）的人，这种更高的可能性更为明显。残疾患者的总体死亡率略高于非残疾患者（调整后的风险比 = 1.08，95% CI：1.06-1.11），尤其是在重度残疾组中（风险比 = 1.20，95% CI： 1.16–1.24）。结论：肺癌和残疾患者，尤其是重度肺癌患者，尽管他们的治疗结果仅比非残疾患者略差，但他们接受的分期检查和治疗较少。