Educational attainment and employment status in lung cancer patients: a nationwide study

Lung cancer remains the leading cause of cancer-related deaths globally, with low-dose computed tomography (LDCT) screening widely implemented in several countries. However, current screening eligibility, based largely on the National Lung Cancer Screening Trial and NELSON trial outcomes, does not account for socioeconomic risk factors such as education and employment status, which may impact lung cancer incidence and outcomes.

This study used data from the Danish National Patient Register to examine educational attainment and employment status among 109,940 lung cancer patients diagnosed between 1994 and 2018, compared to a randomly selected matched general population cohort.

Patients were less likely to hold higher education degrees and more likely to be on disability pension compared to controls, underscoring a significant socioeconomic disparity. Lung cancer patients frequently had only primary school education, with this educational gap widening over time. Employment disparities were also noted, with lung cancer patients twice as likely to be on disability benefits. These findings suggest that socioeconomic vulnerabilities, including educational level and employment, may exacerbate lung cancer risk, possibly linked to higher smoking prevalence and occupational carcinogen exposure in lower socioeconomic groups. Targeted public health initiatives focusing on smoking cessation and LDCT access for socioeconomically disadvantaged individuals are crucial for addressing these disparities and improving lung cancer outcomes. National wealth alone appears insufficient in bridging these socioeconomic gaps, emphasizing the need for strategic, targeted interventions in lung cancer prevention and early detection.