Disparities in survival after Hodgkin lymphoma: a population-based study.
Survival after Hodgkin lymphoma (HL) is generally favorable, but may vary by patient demographic characteristics. The authors examined HL survival according to race/ethnicity and neighborhood socioeconomic status (SES), determined from residential census-block group at diagnosis. For 12,492 classical HL patients ≥ 15 years diagnosed in California during 1988-2006 and followed through 2007, we determined risk of overall and HL-specific death using Cox proportional hazards regression; analyses were stratified by age and Ann Arbor stage. Irrespective of disease stage, patients with lower neighborhood SES had worse overall and HL-specific survival than patients with higher SES. Patients with the lowest quintile of neighborhood SES had a 64% (patients aged 15-44 years) and 36% (≥ 45 years) increased risk of HL-death compared to patients with the highest quintile of SES; SES results were similar for overall survival. Even after adjustment for neighborhood SES, blacks and Hispanics had increased risks of HL-death 74% and 43% (15-44 years) and 40% and 17% (≥ 45 years), respectively, higher than white patients. The racial/ethnic differences in survival were evident for all stages of disease. These data provide evidence for substantial, and probably remediable, racial/ethnic and neighborhood SES disparities in HL outcomes.
Keegan
Theresa H M
TH
Northern California Cancer Center, 2201 Walnut Ave, Suite 300, Fremont, CA 94536, USA. tkeegan@nccc.org
Clarke
Christina A
CA
Chang
Ellen T
ET
Shema
Sarah J
SJ
Glaser
Sally L
SL
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D054624:Health Status Disparities; D006689:Hodgkin Disease / Q000191:economics / Q000453:epidemiology / Q000208:ethnology / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011153:Population; D044469:Racial Groups / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D016019:Survival Analysis; D055815:Young Adult