Excess Mortality by Multimorbidity, Socioeconomic, and Healthcare Factors, amongst Patients Diagnosed with Diffuse Large B-Cell or Follicular Lymphoma in England

(1) Background: Socioeconomic inequalities of survival in patients with lymphoma persist, which may be explained by patients’ comorbidities. We aimed to assess the association between comorbidities and the survival of patients diagnosed with diffuse large B-cell (DLBCL) or follicular lymphoma (FL) i...

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Autores principales:	Matthew James Smith, Aurélien Belot, Matteo Quartagno, Miguel Angel Luque Fernandez, Audrey Bonaventure, Susan Gachau, Sara Benitez Majano, Bernard Rachet, Edmund Njeru Njagi
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	cancer epidemiology diffuse large B-cell lymphoma follicular lymphoma survival analysis comorbidity multimorbidity Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/7a192f9b84f74481aeb68b127d3ccbe3
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spelling	oai:doaj.org-article:7a192f9b84f74481aeb68b127d3ccbe32021-11-25T17:04:18ZExcess Mortality by Multimorbidity, Socioeconomic, and Healthcare Factors, amongst Patients Diagnosed with Diffuse Large B-Cell or Follicular Lymphoma in England10.3390/cancers132258052072-6694https://doaj.org/article/7a192f9b84f74481aeb68b127d3ccbe32021-11-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/22/5805https://doaj.org/toc/2072-6694(1) Background: Socioeconomic inequalities of survival in patients with lymphoma persist, which may be explained by patients’ comorbidities. We aimed to assess the association between comorbidities and the survival of patients diagnosed with diffuse large B-cell (DLBCL) or follicular lymphoma (FL) in England accounting for other socio-demographic characteristics. (2) Methods: Population-based cancer registry data were linked to Hospital Episode Statistics. We used a flexible multilevel excess hazard model to estimate excess mortality and net survival by patient’s comorbidity status, adjusted for sociodemographic, economic, and healthcare factors, and accounting for the patient’s area of residence. We used the latent normal joint modelling multiple imputation approach for missing data. (3) Results: Overall, 15,516 and 29,898 patients were diagnosed with FL and DLBCL in England between 2005 and 2013, respectively. Amongst DLBCL and FL patients, respectively, those in the most deprived areas showed 1.22 (95% confidence interval (CI): 1.18–1.27) and 1.45 (95% CI: 1.30–1.62) times higher excess mortality hazard compared to those in the least deprived areas, adjusted for comorbidity status, age at diagnosis, sex, ethnicity, and route to diagnosis. (4) Conclusions: Deprivation is consistently associated with poorer survival among patients diagnosed with DLBCL or FL, after adjusting for co/multimorbidities. Comorbidities and multimorbidities need to be considered when planning public health interventions targeting haematological malignancies in England.Matthew James SmithAurélien BelotMatteo QuartagnoMiguel Angel Luque FernandezAudrey BonaventureSusan GachauSara Benitez MajanoBernard RachetEdmund Njeru NjagiMDPI AGarticlecancer epidemiologydiffuse large B-cell lymphomafollicular lymphomasurvival analysiscomorbiditymultimorbidityNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5805, p 5805 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	cancer epidemiology diffuse large B-cell lymphoma follicular lymphoma survival analysis comorbidity multimorbidity Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	cancer epidemiology diffuse large B-cell lymphoma follicular lymphoma survival analysis comorbidity multimorbidity Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Matthew James Smith Aurélien Belot Matteo Quartagno Miguel Angel Luque Fernandez Audrey Bonaventure Susan Gachau Sara Benitez Majano Bernard Rachet Edmund Njeru Njagi Excess Mortality by Multimorbidity, Socioeconomic, and Healthcare Factors, amongst Patients Diagnosed with Diffuse Large B-Cell or Follicular Lymphoma in England
description	(1) Background: Socioeconomic inequalities of survival in patients with lymphoma persist, which may be explained by patients’ comorbidities. We aimed to assess the association between comorbidities and the survival of patients diagnosed with diffuse large B-cell (DLBCL) or follicular lymphoma (FL) in England accounting for other socio-demographic characteristics. (2) Methods: Population-based cancer registry data were linked to Hospital Episode Statistics. We used a flexible multilevel excess hazard model to estimate excess mortality and net survival by patient’s comorbidity status, adjusted for sociodemographic, economic, and healthcare factors, and accounting for the patient’s area of residence. We used the latent normal joint modelling multiple imputation approach for missing data. (3) Results: Overall, 15,516 and 29,898 patients were diagnosed with FL and DLBCL in England between 2005 and 2013, respectively. Amongst DLBCL and FL patients, respectively, those in the most deprived areas showed 1.22 (95% confidence interval (CI): 1.18–1.27) and 1.45 (95% CI: 1.30–1.62) times higher excess mortality hazard compared to those in the least deprived areas, adjusted for comorbidity status, age at diagnosis, sex, ethnicity, and route to diagnosis. (4) Conclusions: Deprivation is consistently associated with poorer survival among patients diagnosed with DLBCL or FL, after adjusting for co/multimorbidities. Comorbidities and multimorbidities need to be considered when planning public health interventions targeting haematological malignancies in England.
format	article
author	Matthew James Smith Aurélien Belot Matteo Quartagno Miguel Angel Luque Fernandez Audrey Bonaventure Susan Gachau Sara Benitez Majano Bernard Rachet Edmund Njeru Njagi
author_facet	Matthew James Smith Aurélien Belot Matteo Quartagno Miguel Angel Luque Fernandez Audrey Bonaventure Susan Gachau Sara Benitez Majano Bernard Rachet Edmund Njeru Njagi
author_sort	Matthew James Smith
title	Excess Mortality by Multimorbidity, Socioeconomic, and Healthcare Factors, amongst Patients Diagnosed with Diffuse Large B-Cell or Follicular Lymphoma in England
title_short	Excess Mortality by Multimorbidity, Socioeconomic, and Healthcare Factors, amongst Patients Diagnosed with Diffuse Large B-Cell or Follicular Lymphoma in England
title_full	Excess Mortality by Multimorbidity, Socioeconomic, and Healthcare Factors, amongst Patients Diagnosed with Diffuse Large B-Cell or Follicular Lymphoma in England
title_fullStr	Excess Mortality by Multimorbidity, Socioeconomic, and Healthcare Factors, amongst Patients Diagnosed with Diffuse Large B-Cell or Follicular Lymphoma in England
title_full_unstemmed	Excess Mortality by Multimorbidity, Socioeconomic, and Healthcare Factors, amongst Patients Diagnosed with Diffuse Large B-Cell or Follicular Lymphoma in England
title_sort	excess mortality by multimorbidity, socioeconomic, and healthcare factors, amongst patients diagnosed with diffuse large b-cell or follicular lymphoma in england
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/7a192f9b84f74481aeb68b127d3ccbe3
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Excess Mortality by Multimorbidity, Socioeconomic, and Healthcare Factors, amongst Patients Diagnosed with Diffuse Large B-Cell or Follicular Lymphoma in England

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