Highlights of the Issue

LUNG CANCER OUTCOMES AND THE INVERSE CARE/NEED A CAR LAW. Cancer and pleural disease are our first 2015 themed issue. Four excellent lung cancer papers and a linked editorial by Mick Peake (see page 108) highlight marked inequalities in access to lung cancer care as a result of socioeconomic and geographic factors. Forrest et al (see page 138; Editors’ choice) suggest that this is due to less access to treatment, although O’Dowd et al (see page 161) propose that delayed diagnosis remains a potentially important cause of early death. Mick Peake reminds us that the inverse care law is alive and kicking in housing estates near you and suggests that we need to be much smarter in targeting public health campaigns to these areas. Living far way from a specialist surgical centre also emerged as a risk factor for early lung cancer death. Two papers from the UK and Australia respectively (see page 146; page 152) show that this is associated with a reduced lung cancer resection rate. Finding solutions to these inequalities is not straightforward, particularly in Australia where distances between patients and the surgical centre might be several hundred kilometres. It is still true that it’s better to be rich and ill than poor and ill; even in the UK, riches buy you a better class of enemy, mobility and better NHS treatment.