{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T21:50:47Z","timestamp":1788385847043,"version":"build-2803163510"},"reference-count":45,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2024,4,8]],"date-time":"2024-04-08T00:00:00Z","timestamp":1712534400000},"content-version":"unspecified","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Heidi Anders\u00e9n","award":["100474"],"award-info":[{"award-number":["100474"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,3,25]]},"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A follow-up to a cross-sectional, mixed-methods, single-centre study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A Nordic, tertiary cancer clinic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Not applicable as this was an observational study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>The study\u2019s primary endpoint was the rate of guideline adherence. The secondary endpoint involved assessing treatment toxicity in the form of adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Guideline-adherent treatment was observed in 114 (82.6%) cases. First-line treatment selection appeared uninfluenced by participants\u2019 education, occupation, income or self-reported health literacy. A minority (3.6%) experienced difficulties following treatment instructions, primarily with oral cancer medications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-084689","type":"journal-article","created":{"date-parts":[[2024,4,8]],"date-time":"2024-04-08T21:30:10Z","timestamp":1712611810000},"page":"e084689","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Role of patient characteristics in adherence to first-line treatment guidelines in breast, lung and prostate cancer: insights from the Nordic healthcare system"],"prefix":"10.1136","volume":"14","author":[{"given":"Niclas","family":"Sandstr\u00f6m","sequence":"first","affiliation":[{"name":"Department of Oncology, Vaasa Central Hospital, Vaasa, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilia","family":"Lepp\u00e4l\u00e4","sequence":"additional","affiliation":[{"name":"Vaasa Central Hospital, Vaasa, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antti","family":"Jekunen","sequence":"additional","affiliation":[{"name":"Department of Oncology, Vaasa Central Hospital, Vaasa, Finland"},{"name":"Oncology, University of Turku Faculty of Medicine, Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikael","family":"Johansson","sequence":"additional","affiliation":[{"name":"Department of Diagnostics and Intervention Oncology, Ume\u00e5 University, Umea, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5923-5865","authenticated-orcid":false,"given":"Heidi","family":"Anders\u00e9n","sequence":"additional","affiliation":[{"name":"Vaasa Central Hospital, Vaasa, Finland"},{"name":"Oncology, University of Turku Faculty of Medicine, Turku, Finland"},{"name":"Respiratory Medicine, Tampere University, Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,4,8]]},"reference":[{"key":"2025121408412980000_14.4.e084689.1","doi-asserted-by":"crossref","DOI":"10.3389\/fpubh.2020.00231","article-title":"Socioeconomic status and access to healthcare: interrelated drivers for healthy aging","volume":"8","author":"McMaughan","year":"2020","journal-title":"Front Public Health"},{"key":"2025121408412980000_14.4.e084689.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2021.08.009"},{"key":"2025121408412980000_14.4.e084689.3","unstructured":"World Health Organization, Division of Health Promotion E, and Communication . 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