Disparities by race, age, and sex in the improvement of survival for lymphoma: Findings from a population-based study

Abstract

ObjectiveTo evaluate improvement in survival of lymphoma patients from 1990 to 2014, stratified by age, sex and race using Surveillance Epidemiology and End-Result Survey Program (SEER) data.Study design and settingWe identified 113,788 incident lymphoma cases from nine SEER cancer registries were followed up for cause-specific mortality from lymphoma. Cox proportional hazard regression was used to estimate hazard ratios (HRs) and their respective 95% confidence interval (CIs) for various time periods within groups stratified by race, age and sex.ResultsFive-year survival for Hodgkin’s lymphoma (HL) was 89% for patients 20–49 years of age. For this age group, compared to 1990–1994, survival significantly improved in 2000–2004 (HR = 0.65; 95% CI: 0.54–0.78), 2005–2009 (HR = 0.46, 95% CI: 0.38–0.57) and 2010–2014 (HR = 0.29, 95% CI: 0.20–0.41). Hodgkin’s lymphoma patients aged 75–85 years had 5-year survival of 37% and in these patients, compared to 1990-1994, survival only improved from 2005 onward (HR = 0.67, 95% CI: 0.50–0.90). In patients with non-Hodgkin’s Lymphoma (NHL), all age groups showed survival improvements between 1990–1994 period and 2010–2014 period. Improvements in HL and NHL survival were seen for all race categories and both genders.ConclusionSurvival among US lymphoma patients has improved substantially between 1990–1994 period and 2010–2014 period, though disease-specific mortality was still higher in older age groups.

Sampling‐based estimation for massive survival data with additive hazards model

“…The SEs of OSP‐based estimators are smaller than those of UNIF. The effects of age and gender are positive, which agree with the findings in Mukhtar et al 18 Moreover, it seems that age () is a significant risk factor. To further check the rationality of our method, we give bias, ESE and SSE of the subsample‐based estimates based on 1000 subsamples in Table 6, where r = 200, 400, and 600, respectively.…”

Racial/ethnic, age and sex disparities in leukemia survival among adults in the United States during 1973-2014 period

“…We constructed approximate 10-year time periods to minimize small sample bias in our sub-group analysis. We assessed for interactions of the year of diagnosis with race/ethnicity, age and sex, respectively, for each of the four categories of leukemia using likelihood ratio tests [17,18], following similar strategy in our prior works [19,20], in which race/ethnicity, age or sex were included in multivariate models as covariates when they were not involved with interactions alongside marital status and cancer registry site.…”

Cancer statistics for adults aged 85 years and older, 2019

“…Poorer survival in the oldest old patients with cancer in part reflects the numerous challenges with cancer treatment in this population, as previously discussed. However, studies also suggest that older patients have benefited less than younger patients from recent advances in cancer therapeutics, whether because of lower efficacy or use of ineffective doses . One study found that smaller improvements in survival for older versus younger patients with cancer from 1990 to 2009 for 6 leading cancers led to widening age‐related disparities .…”

“…However, studies also suggest that older patients have benefited less than younger patients from recent advances in cancer therapeutics, whether because of lower efficacy or use of ineffective doses. 94,95 One study found that smaller improvements in survival for older versus younger patients with cancer from 1990 to 2009 for 6 leading cancers led to widening agerelated disparities. 95 Balancing the risks of undertreatment versus overtreatment is critical for older patients who have cancer.…”