title: The impact of race, age, and sex in follicular lymphoma: A comprehensive SEER analysis across consecutive treatment eras.
abstract: The impact of race/ethnicity and the additional factors of age, sex, and socioeconomic status (SES) on follicular lymphoma (FL) outcomes have not been comprehensively studied and are not well defined. We examined population-based FL data from >18,000 patients in SEER-13 (1992-2009) investigating race/ethnicity and the impact of relevant factors including sex, age, and SES. Further, we compared data over two consecutive periods: Era-1 (1992-2000, n = 8,355) and Era-2 (2001-2009, n = 10,475). We identified 18,830 FL patients (White: n = 15,116; Hispanic: n = 1,627; Asian/Pacific Islander (A/PI): n = 1,002; and Black: n = 846). Median ages (years) differed significantly by race/ethnicity: White: 62.1, Hispanic: 57.3, A/PI: 60.7, and Black: 56.8 (P < 0.01 each race versus White). Overall survival (OS) was superior in Era-2 versus Era-1 for all patients (5-year: 76.7% versus 67.4%, respectively, P < 0.001). Further, survival was significantly improved for all age groups <80 years, for males (P = 0.0019), and females (P < 0.001) across eras. Females had superior OS compared with males in Era-1 (P = 0.004), but not in Era-2. Additionally, all races, except A/PI, had improved 5-year OS rates from Era-1 to Era-2. Finally, OS improved across eras for lower and higher SES populations; however those with higher SES were superior to lower SES patients in both eras. In conclusion, and in the largest comprehensive evaluation of US-based FL patients to date, we show that despite improvements in OS for FL over time, critical disparities across races/ethnicities, sex, and age groups remain in the modern era and warrant further studies.
authors.affiliation: Section of Hematology and Oncology, Department of Medicine, The University of Chicago, Chicago, Illinois.
authors.forename: Chadi
authors.initials: C
authors.lastname: Nabhan
authors.forename: Briseis
authors.initials: B
authors.lastname: Aschebrook-Kilfoy
authors.forename: Brian C-H
authors.initials: BC
authors.lastname: Chiu
authors.forename: Kimberly
authors.initials: K
authors.lastname: Kruczek
authors.forename: Sonali M
authors.initials: SM
authors.lastname: Smith
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Evens
mesh_terms: D000367:Age Factors; D000368:Aged; D018572:Disease-Free Survival; D005006:Ethnicity; D005260:Female; D006801:Humans; D008224:Lymphoma, Follicular / Q000453:epidemiology* / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D018426:SEER Program; D012737:Sex Factors; D012923:Social Class; D016019:Survival Analysis; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology