Socioeconomic position and surgery for early-stage non-small-cell lung cancer: A population-based study in Denmark.

AIM: To examine possible associations between socioeconomic position and surgical treatment of patients with early-stage non-small-cell lung cancer (NSCLC). METHODS: In a register-based clinical cohort study, patients with early-stage (stages I-IIIa) NSCLC were identified in the Danish Lung Cancer Register 2001-2008 (date of diagnosis, histology, stage, and treatment), the Central Population Register (vital status), the Integrated Database for Labour Market Research (socioeconomic position), and the Danish Hospital Discharge Register (comorbidity). Logistic regression analyses were performed overall and separately for stages I, II and IIIa. RESULTS: Of the 5538 eligible patients with stages I-IIIa NSCLC diagnosed 2001-2008, 53% underwent surgery. Higher stage, older age, being female and diagnosis early in the study period were associated with higher odds for not receiving surgery. Low disposable income was associated with greater odds for no surgery in stage I and stage II patients as was living alone for stage I patients. Comorbidity, a short diagnostic interval and small diagnostic volume were all associated with higher odds for not undergoing surgery; but these factors did not appear to explain the association with income or living alone for early-stage NSCLC patients. CONCLUSION: Early-stage NSCLC patients with low income or who live alone are less likely to undergo surgery than those with a high income or who live with a partner, even after control for possible explanatory factors. Thus, even in a health care system with free, equal access to health services, disadvantaged groups are less likely to receive surgery for lung cancer.

Erythropoietin and erythropoietin receptor expression in the guinea pig inner ear.

The erythropoietin receptor (EPOR) is expressed in the brain and erythropoietin (EPO) has been shown to have neurotrophic and neuroprotective functions in the central nervous system and in the retina. These findings may be applied to the inner ear, pending EPO receptor presence. Accordingly, this study determines expression of EPO and EPOR in the inner ear of the guinea pig. Normal guinea pig inner ears were processed for immunohistochemistry, using poly-clonal antibodies against EPO and the EPO receptor. EPO expression was exclusively found in most, but not all spiral ganglion neurons. Expression of the EPO receptor was found in the cytoplasm of the inner and outer phalangeal cells (Deiters' cells), as well as the inner sulcus cells and the supporting cells of the organ of Corti (Hensen, Claudius and some Boettcher cells). Some spiral ganglion neurons or glial cells expressed the receptor, as did spiral ligament fibrocytes, some intermediate cells of stria vascularis and the endothelial cells of some modiolar vessels. No parts of the vestibular system stained positive for either antibody. We conclude, that EPO is expressed by spiral ganglion neurons and that the EPO receptor is widely expressed by several cell types within the guinea pig cochlea. We hypothesize on the existence of a local paracrine system and that EPO treatment may be feasible following inner ear damage.