Racial Disparities in Survival Among Non-Hodgkin Lymphoma Patients: An Analysis of the SEER Database (2007-2015)

Abstract

Introduction Although disparities in cancer survival exist across different races/ethnicity, the underlying factors are not fully understood. Aim To identify the interaction between race/ethnicity and insurance type and how this influences survival among non-Hodgkins lymphoma (NHL) patients. Methods We utilized the SEER (Surveillance, Epidemiology, and End Results) Registry to identify patients with a primary diagnosis of NHL from 2007 to 2015. Our primary outcome of interest was the hazard of death following a diagnosis of NHL. In addition, we utilized the Cox regression model to explore the interaction between race and insurance type and how this influences survival among NHL patients. Results There were 44,609 patients with NHL who fulfilled the study criteria. The mean age at diagnosis was 50.9 ± 10.8 years, with a mean survival of 49.8± 34.5 months. Among these patients, 64.8% were non-Hispanic Whites, 16% were Hispanics, and 10.8% were Blacks. In addition, 76.5% of the study population had private insurance, 16.6% had public insurance, and 6.9% were uninsured. Blacks had the worst survival (HR=1.66; 95% = 1.55-1.78). Patients on private insurance had better survival compared to those with public insurance (HR=2.11; 95% CI=2.00-2.24) Conclusion The racial and socioeconomic disparity in survival outcomes among patients with NHL persisted despite controlling for treatment modalities, age, and disease stage.

Incidence and survival of second primary non-Hodgkin lymphoma: A Surveillance, Epidemiology, and End Results-based cohort study

“…In a cohort of 1,605 patients with Hodgkin lymphoma treated in the Children’s Oncology Group trials between 2002 and 2012,69 non-White patients (pooled Black and Hispanic) had a 1.88 -fold increased risk of mortality in multivariable analyses [ 23 ]. Abodunrin et al found significant differences in the disease distribution and relative survival of NHL patients among the different racial groups in the United States [ 24 ]. Li et al found a significantly higher five-year relative survival in Whites with stages I-IV DLBCL compared to Blacks, Asians, and Pacific Islanders, while Blacks have the worst five-year relative survival among patients with stage I-III, and Asians/Pacific Islanders have the worst survival in stage IV [ 25 ].…”