Role of patient characteristics in adherence to first-line treatment guidelines in breast, lung and prostate cancer: insights from the Nordic healthcare system

Abstract

<p><strong>Objectives</strong> This study investigates the influence of socioeconomic status, health literacy, and numeracy on treatment decisions and the occurrence of adverse events in patients with breast, lung, and prostate cancer within a Nordic healthcare setting.</p><p><strong>Design</strong> A follow-up to a cross-sectional, mixed-methods, single-centre study.</p><p><strong>Setting</strong> A Nordic, tertiary cancer clinic.</p><p><strong>Participants</strong> A total of 244 participants with breast, lung and prostate cancer were initially identified, of which 138 first-line treatment participants were eligible for this study. First-line treatment participants (n=138) surpassed the expected cases (n=108).</p><p><strong>Interventions</strong> Not applicable as this was an observational study.</p><p><strong>Primary and secondary outcome measures</strong> The study’s primary endpoint was the rate of guideline adherence. The secondary endpoint involved assessing treatment toxicity in the form of adverse events.</p><p><strong>Results</strong> Guideline-adherent treatment was observed in 114 (82.6%) cases. First-line treatment selection appeared uninfluenced by participants’ education, occupation, income or self-reported health literacy. A minority (3.6%) experienced difficulties following treatment instructions, primarily with oral cancer medications.</p><p><strong>Conclusions</strong> The findings indicated lesser cancer health disparities regarding guideline adherence and treatment toxicity within the Nordic healthcare framework. A causal connection may not be established; however, the findings contribute to discourse on equitable cancer health provision.</p>