@article {Carbonnaux1502, author = {M{\'e}lodie Carbonnaux and Pierre-Jean Souquet and Anne-Pascale Meert and Arnaud Scherpereel and Matthew Peters and S{\'e}bastien Couraud}, title = {Inequalities in lung cancer: a world of EGFR}, volume = {47}, number = {5}, pages = {1502--1509}, year = {2016}, doi = {10.1183/13993003.01157-2015}, publisher = {European Respiratory Society}, abstract = {Epidermal growth factor receptor gene (EGFR) mutation status has emerged as a crucial issue in lung cancer management. Availability and cost of tests and tyrosine kinase inhibitors (TKIs) may vary as a function of country development.We conducted a prospective specialist opinion survey to map EGFR test and EGFR-TKI availability and detect associations with the Human Development Index (HDI). A questionnaire was sent to specialists in thoracic oncology in all United Nations Member States.We obtained responses from 74 countries, comprising 78\% of the worldwide population. Nonresponding countries had significantly lower HDI rank than responding countries. EGFR mutation analysis was routinely available in 57 countries (70\% of the worldwide population). The cost of the test was \<US$500 in 49 countries (42.5\% of the worldwide population). Test availability and cost were both significantly linked to HDI. Erlotinib, gefitinib, afatinib and icotinib were routinely available in 75\%, 66\%, 31\% and 23\% of the worldwide population, respectively, also associated with HDI.EGFR mutation testing and EGFR-TKIs are widely accessible in routine practice worldwide. However, there are large discrepancies in access to this innovative treatment path and in its cost for patients as a function of country development.Availability and cost of EGFR tests and TKI drugs are tightly associated with a country{\textquoteright}s Human Development Index http://ow.ly/Y79G8}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/47/5/1502}, eprint = {https://erj.ersjournals.com/content/47/5/1502.full.pdf}, journal = {European Respiratory Journal} }