Socioeconomic inequalities in treatment and relative survival among patients with diffuse large B-cell lymphoma: a Hong Kong population-based study

Abstract The influence of socioeconomic status (SES) on access to standard chemotherapy and/or monoclonal antibody therapy, and associated secular trends, relative survival, and excess mortality, among diffuse large B-cell lymphoma (DLBCL) patients is not clear. We conducted a Hong Kong population-b...

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Autores principales:	Shing Fung Lee, Andrew M. Evens, Andrea K. Ng, Miguel-Angel Luque-Fernandez
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/44933f225a014fc7adbe380c4e55a037
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spelling	oai:doaj.org-article:44933f225a014fc7adbe380c4e55a0372021-12-02T17:41:17ZSocioeconomic inequalities in treatment and relative survival among patients with diffuse large B-cell lymphoma: a Hong Kong population-based study10.1038/s41598-021-97455-52045-2322https://doaj.org/article/44933f225a014fc7adbe380c4e55a0372021-09-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-97455-5https://doaj.org/toc/2045-2322Abstract The influence of socioeconomic status (SES) on access to standard chemotherapy and/or monoclonal antibody therapy, and associated secular trends, relative survival, and excess mortality, among diffuse large B-cell lymphoma (DLBCL) patients is not clear. We conducted a Hong Kong population-based cohort study and identified adult patients with histologically diagnosed DLBCL between 2000 and 2018. We examined the association of SES levels with the odds and the secular trends of receipt of chemotherapy and/or rituximab. Additionally, we estimated the long-term relative survival by SES utilizing Hong Kong life tables. Among 4017 patients with DLBCL, 2363 (58.8%) patients received both chemotherapy and rituximab and 740 (18.4%) patients received chemotherapy alone, while 1612 (40.1%) and 914 (22.8%) patients received no rituximab or chemotherapy, respectively. On multivariable analysis, low SES was associated with lesser use of chemotherapy (odd ratio [OR] 0.44; 95% CI 0.34–0.57) and rituximab (OR 0.41; 95% CI 0.32–0.52). The socioeconomic disparity for either treatment showed no secular trend of change. Additionally, patients with low SES showed increased excess mortality, with a hazard ratio of 2.34 (95% CI 1.67–3.28). Improving survival outcomes for patients with DLBCL requires provision of best available medical care and securing access to treatment regardless of patients’ SES.Shing Fung LeeAndrew M. EvensAndrea K. NgMiguel-Angel Luque-FernandezNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Shing Fung Lee Andrew M. Evens Andrea K. Ng Miguel-Angel Luque-Fernandez Socioeconomic inequalities in treatment and relative survival among patients with diffuse large B-cell lymphoma: a Hong Kong population-based study
description	Abstract The influence of socioeconomic status (SES) on access to standard chemotherapy and/or monoclonal antibody therapy, and associated secular trends, relative survival, and excess mortality, among diffuse large B-cell lymphoma (DLBCL) patients is not clear. We conducted a Hong Kong population-based cohort study and identified adult patients with histologically diagnosed DLBCL between 2000 and 2018. We examined the association of SES levels with the odds and the secular trends of receipt of chemotherapy and/or rituximab. Additionally, we estimated the long-term relative survival by SES utilizing Hong Kong life tables. Among 4017 patients with DLBCL, 2363 (58.8%) patients received both chemotherapy and rituximab and 740 (18.4%) patients received chemotherapy alone, while 1612 (40.1%) and 914 (22.8%) patients received no rituximab or chemotherapy, respectively. On multivariable analysis, low SES was associated with lesser use of chemotherapy (odd ratio [OR] 0.44; 95% CI 0.34–0.57) and rituximab (OR 0.41; 95% CI 0.32–0.52). The socioeconomic disparity for either treatment showed no secular trend of change. Additionally, patients with low SES showed increased excess mortality, with a hazard ratio of 2.34 (95% CI 1.67–3.28). Improving survival outcomes for patients with DLBCL requires provision of best available medical care and securing access to treatment regardless of patients’ SES.
format	article
author	Shing Fung Lee Andrew M. Evens Andrea K. Ng Miguel-Angel Luque-Fernandez
author_facet	Shing Fung Lee Andrew M. Evens Andrea K. Ng Miguel-Angel Luque-Fernandez
author_sort	Shing Fung Lee
title	Socioeconomic inequalities in treatment and relative survival among patients with diffuse large B-cell lymphoma: a Hong Kong population-based study
title_short	Socioeconomic inequalities in treatment and relative survival among patients with diffuse large B-cell lymphoma: a Hong Kong population-based study
title_full	Socioeconomic inequalities in treatment and relative survival among patients with diffuse large B-cell lymphoma: a Hong Kong population-based study
title_fullStr	Socioeconomic inequalities in treatment and relative survival among patients with diffuse large B-cell lymphoma: a Hong Kong population-based study
title_full_unstemmed	Socioeconomic inequalities in treatment and relative survival among patients with diffuse large B-cell lymphoma: a Hong Kong population-based study
title_sort	socioeconomic inequalities in treatment and relative survival among patients with diffuse large b-cell lymphoma: a hong kong population-based study
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/44933f225a014fc7adbe380c4e55a037
work_keys_str_mv	AT shingfunglee socioeconomicinequalitiesintreatmentandrelativesurvivalamongpatientswithdiffuselargebcelllymphomaahongkongpopulationbasedstudy AT andrewmevens socioeconomicinequalitiesintreatmentandrelativesurvivalamongpatientswithdiffuselargebcelllymphomaahongkongpopulationbasedstudy AT andreakng socioeconomicinequalitiesintreatmentandrelativesurvivalamongpatientswithdiffuselargebcelllymphomaahongkongpopulationbasedstudy AT miguelangelluquefernandez socioeconomicinequalitiesintreatmentandrelativesurvivalamongpatientswithdiffuselargebcelllymphomaahongkongpopulationbasedstudy
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Socioeconomic inequalities in treatment and relative survival among patients with diffuse large B-cell lymphoma: a Hong Kong population-based study

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