Differences in survival among multiple myeloma patients in the United States SEER population by neighborhood socioeconomic status and race/ethnicity

Abstract

Purpose-We examined the combined influences of race/ethnicity and neighborhood socioeconomic status (SES) on long-term survival among patients with multiple myeloma (MM).Methods-Data from the 2000-2015 NCI Surveillance, Epidemiology, and End Results Program (SEER-18) were used. Census tract-level SES index was assessed in tertiles (low, medium, high SES). Competing-risk modeling was used to estimate sub-hazard ratios (SHR) and 95% confidence intervals (CIs) for SES tertile adjusted for sex and age at diagnosis and stratified by race/ethnicity.Results-Overall, living in a low SES neighborhood was associated with worse MM survival. However, we observed some variation in the association by racial/ethnic group. Living in a low versus a high SES neighborhood was associated with a 35% (95% CI = 1.16-1.57) increase in MM-specific mortality risk among Asian/Pacific Islander cases, a 17% (95% CI = 1.12-1.22) increase among White cases, a 14% (95% CI = 1.04-1.23) increase among Black cases, and a 7% (95% CI = 0.96-1.19) increase among Hispanic cases.Conclusion-These results suggest that the influence of both SES and race/ethnicity should be considered when considering interventions to remedy disparities in MM survival.

Disparities in All-cancer and Lung Cancer Survival by Social, Behavioral, and Health Status Characteristics in the United States: A Longitudinal Follow-up of the 1997-2015 National Health Interview Survey-National Death Index Record Linkage Study

“…Persistence of marked disparities in cancer survivorship among racial/ethnic and SES groups might reflect healthcare access and treatment disparities and shows the potential for further improvements in cancer survival [ 5 , 33 ]. Future research is needed to examine differentials in survival rates by neighborhood SES or built environmental factors, levels of urbanization/rurality [ 10 , 33 , 34 ], social supports [ 35 ], or quality of health care [ 36 - 38 ]. Although we focused on individual-level SES factors due to data availability, area-based SES has been strongly associated with cancer survival [ 10 , 33 , 34 ].…”

“…Future research is needed to examine differentials in survival rates by neighborhood SES or built environmental factors, levels of urbanization/rurality [ 10 , 33 , 34 ], social supports [ 35 ], or quality of health care [ 36 - 38 ]. Although we focused on individual-level SES factors due to data availability, area-based SES has been strongly associated with cancer survival [ 10 , 33 , 34 ]. Cancer patients in neighborhoods with lower SES have markedly lower survival rates than those in higher SES neighborhoods [ 10 , 33 , 34 ].…”

“…Although we focused on individual-level SES factors due to data availability, area-based SES has been strongly associated with cancer survival [ 10 , 33 , 34 ]. Cancer patients in neighborhoods with lower SES have markedly lower survival rates than those in higher SES neighborhoods [ 10 , 33 , 34 ]. Furthermore, it would be important to determine if similar individual patient-level socio-behavioral inequalities in survival exist for other major cancer sites such as colorectal, prostate, breast, and cervical cancer.…”

Diversity upon diversity: linking DNA double-strand break repair to blood cancer health disparities

“…Blacks are also much more likely to have MM with translocations involving IgH. Furthermore, epidemiological data clearly show that socioeconomic factors and low recruitment to clinical trials worsens the prognosis of MM in this population [57,58] (Box 3).…”

Sozioökonomische Benachteiligung als Risikofaktor für Krebserkrankungen – „closing the care gap“

“…Aber aktuelle Forschungsbemühungen zeigten, dass die aufgeführten sozioökonomische Aspekte inkl. Einkommen, Beziehungs- und Sozialstatus sowie Notwendigkeit für sozialmedizinische Unterstützungsangebote systematischer erhoben werden müssen [ 28 , 30 , 31 ]. In eigenen Untersuchungen mit Patient*innen mit multiplem Myelom (MM) hatten 10 % der Studienteilnehmenden ein geringes Einkommen (definiert als < 1025 $/Monat) und 14 % waren ohne Partner*in/allein [ 32 ], was sich in einer prospektiven, randomisierten Sportinterventionsstudie mit Patient*innen mit MM (Manuskript in Vorbereitung) sogar als doppelt so hoch mit 19 % bzw.…”