Education level as a predictor of survival in patients with multiple myeloma

Abstract

Background: Disparities in multiple myeloma (MM) prognosis based on sociodemographic factors may exist. We investigated whether education level at diagnosis influenced Chinese MM patient outcomes. Methods: We performed a multicenter retrospective analysis of data from 773 MM patients across 9 centers in China from 2006 to 2019. Sociodemographic and clinical factors at diagnosis and treatment regimens were recorded, and univariate and multivariate analyses were performed. Results: Overall, 69.2% of patients had low education levels. Patients with low education levels differed from those with high education levels in that they were more likely to be older, and a higher proportion lived in rural areas, were unemployed, had lower annual incomes and lacked insurance. Additionally, compared to patients with high education levels, patients with low education levels had a higher proportion of international staging system (ISS) stage III classification and elevated lactate dehydrogenase (LDH) levels and underwent transplantation less often. Patients with high education levels had a median progression-free survival (PFS) of 67.50 (95% confidence interval (CI): 51.66-83.39) months, which was better than that of patients with low education levels (30.60 months, 95% CI: 27.38-33.82, p < 0.001). Similarly, patients with high education levels had a median overall survival (OS) of 122.27 (95% CI: 117.05-127.49) months, which was also better than that of patients with low education levels (58.83 months, 95% CI: 48.87-62.79, p < 0.001). In the multivariable analysis, patients with high education levels had lower relapse rates and higher survival rates than did those with low education level in terms of PFS and OS (hazard ratio (HR) = 0.50 [95% CI: 0.34-0.72], p < 0.001; HR = 0.32 [0.19-0.56], p < 0.001, respectively). Conclusions: Low education levels may independently predict poor survival in MM patients in China.

Associations of Education Level With Survival Outcomes and Treatment Receipt in Patients With Gastric Adenocarcinoma

“…Similar findings have also been reported for other tumor types ( 10 , 17 – 19 ), indicating that education disparities are imperative public health concerns. Thus, we were interested in the underlying effects of individual education levels for patients with cancer.…”

“…Educational attainment is recognized as a crucial social determinant of diseases; it influences health through mechanisms such as biological aging, cognitive ability, and health behaviors ( 16 ). Education level has been demonstrated to impact treatment and prognoses in anal cancer, sinonasal cancer, and multiple myeloma ( 17 – 19 ). A nationwide cohort study in Sweden indicated that a high education level was associated with a greater likelihood of improved survival rates and curative treatment in 4,112 patients diagnosed with gastroesophageal cancer ( 10 ).…”

The Mediation Effect of Health Literacy on Social Support with Exchange and Depression in Community-Dwelling Middle-Aged and Older People in Taiwan

“…Consistent with Lin et al [ 35 ], according to their age, participants were divided into two groups: 50 to 64 years, and 65 to 85 years. Similar to the levels of education used by Xu et al [ 36 ], the study cohort was also divided into two strata: “junior high school or lower” and “senior high school or above”.…”

Response and Survival Estimates of Patients With Plasma Cell Myeloma in a Resource-Constrained Setting Using Protocols From High-Income Countries: A Single-Center Experience From Sri Lanka

“…Patients treated at LHBCC, established in a self-funding hospital, may attract patients belonging to a higher socioeconomic and education level. Xu et al 39 have previously shown that high education levels may independently predict better survival outcome in patients with PCM in an Asian study. Furthermore, socioeconomic status is a global prognostic factor in PCM survival.…”