No outcome disparities in patients with diffuse large B-cell lymphoma and a low socioeconomic status

Publication date: June 2017
Source:Cancer Epidemiology, Volume 48
Author(s): Karin Boslooper, Mels Hoogendoorn, Eric N. van Roon, Robby E. Kibbelaar, Huib Storm, Sjoerd Hovenga, Gerhard Woolthuis, Bas P. van Rees, Bart Klijs, Nic J.G.M. Veeger, Hanneke C. Kluin-Nelemans, Geertruida H. de Bock
IntroductionIn patients with diffuse large B-cell lymphoma (DLBCL) socioeconomic status (SES) is associated with outcome in several population-based studies. The aim of this study was to further investigate the existence of disparities in treatment and survival.MethodsA population-based cohort study was performed including 343 consecutive patients with DLBCL, diagnosed between 2005 and 2012, in the North-west of the Netherlands. SES was based on the socioeconomic position within the Netherlands by use of postal code and categorized as low, intermediate or high. With multivariable logistic regression and Cox proportional hazard models the association between SES and respectively treatment and overall survival (OS) was evaluated.ResultsTwo-third of patients was positioned in low SES. Irrespective of SES an equal proportion of patients received standard immunochemotherapy. SES was not a significant risk indicator for OS (intermediate versus low SES: hazard ratio (HR) 1.31 (95%CI 0.78–2.18); high versus low SES: HR 0.83 (95%CI 0.48–1.46)). The mortality risk remained significantly increased with higher age, advanced performance status, elevated LDH and presence of comorbidity.ConclusionWithin the setting of free access to health care, in this cohort of patients with DLBCL no disparities in treatment and survival were seen in those with lower SES.



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