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Objectives: To estimate the risk of Long COVID by socioeconomic deprivation and to further examine the inequality by sex and occupation. Design: We conducted a retrospective population-based cohort study using data from the ONS COVID-19 Infection Survey between 26 April 2020 and 31 January 2022. This is the largest nationally representative survey of COVID-19 in the UK with longitudinal data on occupation, COVID-19 exposure and Long COVID. Setting: Community-based survey in the UK. Participants: A total of 201,799 participants aged 16 to 64 years and with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Main outcome measures: The risk of Long COVID at least 4 weeks after SARS-CoV-2 infection by index of multiple deprivation (IMD) and the modifying effects of socioeconomic deprivation by sex and occupation. Results: Nearly 10% (n = 19,315) of participants reported having Long COVID. Multivariable logistic regression models, adjusted for a range of variables (demographic, co-morbidity and time), showed that participants in the most deprived decile had a higher risk of Long COVID (11.4% vs. 8.2%; adjusted odds ratio (aOR): 1.46; 95% confidence interval (CI): 1.34, 1.59) compared to the least deprived decile. Significantly higher inequalities (most vs. least deprived decile) in Long COVID existed in healthcare and patient-facing roles (aOR: 1.76; 95% CI: 1.27, 2.44), in the education sector (aOR: 1.68; 95% CI: 1.31, 2.16) and in women (aOR: 1.56; 95% CI: 1.40, 1.73) than men (aOR: 1.32; 95% CI: 1.15, 1.51). Conclusions: This study provides insights into the heterogeneous degree of inequality in Long COVID by deprivation, sex and occupation. These findings will help inform public health policies and interventions in incorporating a social justice and health inequality lens. [ABSTRACT FROM AUTHOR]

Background: We described patterns of chemotherapy use and outcomes in patients with advanced small-cell lung cancer (SCLC) in relation to age using the Systemic Anti-Cancer Treatment dataset. Method: In total, 7,966 patients SCLC (67.6% stage IV) diagnosed between 2014-17 in England, treated with chemotherapy were followed up through 2017. Patterns of chemotherapy use, 30- and 90- mortality rates, and 6- and 12-month and median overall survival (OS) from the initiation of chemotherapy were compared between those below and above the age of 75. Results : Older patients were 6-7 times less likely to receive curative treatment than younger patients regardless of stage. They had more frequent adjustments of treatment and dose reduction (stage III). There were no age differences in dose reduction in stage IV, treatment delayed or stopped earlier than planned. 30-day mortality rates were similar across age groups in stage III SCLC (~4%). Older patients had higher 90-days mortality rates and poorer OS than younger peers. In both stages, OS decreased around the age of 70-75 and were worse in patients with performance status scores ≥2. Conclusion: This study offers a snapshot of chemotherapy use and outcomes in advanced SCLC, notably in older patients, in the pre-immunotherapy era., Competing Interests: Competing interests: SP, EJAM, DD do not have any conflict to report. KNF reports the following: Active research funding/grant: -Avoiding cardiac toxicity in lung cancer patients treated with curative-intent radiotherapy to improve survival. Co-chief investigator (with Prof Faivre-Finn). Funder Yorkshire Cancer Research (YCR) -PREHABS: Prehabilitation, Radiotherapy Exercise, smoking Habit cessation and Balanced diet Study. Co-chief investigator with Dr Carole Burnett. Funder Yorkshire Cancer Research (YCR) -CONCOrDE- Study Arm Lead in platform trial of DNA-damage repair inhibitors with radical radiotherapy in stage III NSCLC. (CRUK/AstraZenaca joint funding) -Yorkshire Lung Screening Trial Biomarker Trial- Co-investigator and PI for Biomarker sub-study of main trial. Funder Yorkshire Cancer Research (YCR) -UK PI for AstraZeneca PACIFIC-4 Study (currently off license) and CI for AstraZeneca CODAK study Honoraria/Advisory Boards: AstraZeneca, Amgen, Boehringer-Ingelheim, Bristol-Meyers-Squibb, Lilly, Roche and Takeda Educational support: AstraZeneca, Boehringer-Ingelheim, ELEKTA, Pierre Fabre, Novartis, Roche and Takeda., (Copyright: © 2023 Pilleron S et al.)

Objective: Colorectal cancer is a common cause of death and morbidity. A significant amount of data are routinely collected during patient treatment, but they are not generally available for research. The National Institute for Health Research Health Informatics Collaborative in the UK is developing infrastructure to enable routinely collected data to be used for collaborative, cross-centre research. This paper presents an overview of the process for collating colorectal cancer data and explores the potential of using this data source., Methods: Clinical data were collected from three pilot Trusts, standardised and collated. Not all data were collected in a readily extractable format for research. Natural language processing (NLP) was used to extract relevant information from pseudonymised imaging and histopathology reports. Combining data from many sources allowed reconstruction of longitudinal histories for each patient that could be presented graphically., Results: Three pilot Trusts submitted data, covering 12 903 patients with a diagnosis of colorectal cancer since 2012, with NLP implemented for 4150 patients. Timelines showing individual patient longitudinal history can be grouped into common treatment patterns, visually presenting clusters and outliers for analysis. Difficulties and gaps in data sources have been identified and addressed., Discussion: Algorithms for analysing routinely collected data from a wide range of sites and sources have been developed and refined to provide a rich data set that will be used to better understand the natural history, treatment variation and optimal management of colorectal cancer., Conclusion: The data set has great potential to facilitate research into colorectal cancer., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objectives: To identify patterns of age disparities in cancer survival, using colon and lung cancer as exemplars., Design: Systematic review of the literature., Data Sources: We searched Embase, MEDLINE, Scopus and Web of Science through 18 December 2020., Eligibility Criteria: We retained all original articles published in English including patients with colon or lung cancer. Eligible studies were required to be population-based, report survival across several age groups (of which at least one was over the age of 65) and at least one other characteristic (eg, sex, treatment)., Data Extraction and Synthesis: Two independent reviewers extracted data and assessed the quality of included studies against selected evaluation domains from the QUIPS tool, and items concerning statistical reporting. We evaluated age disparities using the absolute difference in survival or mortality rates between the middle-aged group and the oldest age group, or by describing survival curves., Results: Out of 3047 references, we retained 59 studies (20 for colon, 34 for lung and 5 for both sites). Regardless of the cancer site, the included studies were highly heterogeneous and often of poor quality. The magnitude of age disparities in survival varied greatly by sex, ethnicity, socioeconomic status, stage at diagnosis, cancer site, and morphology, the number of nodes examined and treatment strategy. Although results were inconsistent for most characteristics, we consistently observed greater age disparities for women with lung cancer compared with men. Also, age disparities increased with more advanced stages for colon cancer and decreased with more advanced stages for lung cancer., Conclusions: Although age is one of the most important prognostic factors in cancer survival, age disparities in colon and lung cancer survival have so far been understudied in population-based research. Further studies are needed to better understand age disparities in colon and lung cancer survival., Prospero Registration Number: CRD42020151402., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)