Poorer patients are at greater risk of dying of non-Hodgkin lymphoma (NHL) as they could be deprived of chemotherapy.
NHL is a common type of cancer in the elderly. Its incidence has been increasing over the past several decades, and Caucasians have higher incidence and death rates related to the disease than patients in other ethnic groups. Newer treatments for NHL have become available in recent years; however, studies have not addressed ethnic disparities in survival as they relate to treatment, diagnosis, socioeconomic status, or other factors.
To investigate the issue, Dr. Xianglin Du of the University of Texas School of Public Health in Houston and colleagues analyzed SEER (Surveillance, Epidemiology and End Results)-Medicare linked data for more than 13,000 patients diagnosed at age 65 or older between 1992 and 1999. The metropolitan areas of San Francisco/Oakland, Detroit, Atlanta, Seattle, Los Angeles County, San Jose/Monterey, and the states of Connecticut, Iowa, New Mexico, Utah, and Hawaii were included in this study.
Dr. Du and his team analyzed data related to survival, socioeconomic status, treatment (chemotherapy or radiation), tumor factors (stage and type of NHL), the presence of other diseases or conditions, and other characteristics such as age, race, marital status, and geographic area.
The investigators found that receiving chemotherapy was associated with prolonged survival in patients with NHL and that elderly Caucasian patients with NHL were more likely to receive chemotherapy (52.4 percent) compared with African-Americans (43.2 percent). Also, poor socioeconomic status was significantly associated with increased risk of mortality, and there were a larger proportion of African-American patients living in poor communities compared with other ethnicities. No significant differences in the risk of death were seen between African-Americans and Caucasians after controlling for factors such as treatment and socioeconomic status.
The study is published in the December 1, 2008 issue of CANCER
, a peer-reviewed journal of the American Cancer Society.