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Baech J, Jakobsen LH, Simonsen MR, Severinsen MT, Frederiksen H, Niemann CU, Brown P, Jørgensen JM, Dann EJ, Johnsen SP, El-Galaly TC. Survival outcomes and healthcare utilization between immigrant patients and Danish-born patients with hematological cancers: a Danish population-based study. Eur J Epidemiol 2024:10.1007/s10654-024-01139-z. [PMID: 38963616 DOI: 10.1007/s10654-024-01139-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 06/26/2024] [Indexed: 07/05/2024]
Abstract
Overall survival (OS) for patients with a hematological cancer may differ between immigrant and Danish-born patients due to disparities in socioeconomic status, health literacy, and language proficiency. This cohort study aimed to investigate survival and hospitalization according to immigrant status while controlling for confounders. Patients with newly diagnosed hematological cancer in 2000-2020 were identified in the Danish nationwide hematological registers and stratified into Danish-born, Western, and non-Western patients. Patients were followed from diagnosis until death, 31st December 2021, or emigration, whichever came first. Crude OS, standardized OS, and 5-years OS differences were computed using flexible parametric models and hazard ratios using Cox regression. Number of hospitalization days in the year before and after diagnosis, respectively, were calculated using Poisson regression. A total of 2,241 immigrants and 41,519 Danish-born patients with a hematological cancer were included. Standardized 5-years OS was similar between groups with 58% (95% confidence interval 57-58%) for Danish-born patients, 57% (55-60%) for Western, and 56% (53-58%) for non-Western immigrant patients. Subgroup analyses identified OS differences in selected subgroups. Non-Western immigrant patients had 1.3 (0.5-2.1) more hospitalization days in the year before diagnosis and an adjusted incidence rate ratio of hospitalization days of 1.14 (1.13-1.15) in the year after diagnosis compared with Danish-born patients. In conclusion, there were no overall differences in survival when comparing immigrant patients to Danish-born patients after controlling for relevant confounders. Healthcare utilization was slightly higher among non-Western immigrant patients before and after diagnosis, but differences were small on an individual patient level.
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Affiliation(s)
- Joachim Baech
- Department of Haematology, Clinical Cancer Research Unit, Aalborg University Hospital, Mølleparkvej 4, 9000, Aalborg, Denmark.
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
| | - Lasse Hjort Jakobsen
- Department of Haematology, Clinical Cancer Research Unit, Aalborg University Hospital, Mølleparkvej 4, 9000, Aalborg, Denmark
| | - Mikkel Runason Simonsen
- Department of Haematology, Clinical Cancer Research Unit, Aalborg University Hospital, Mølleparkvej 4, 9000, Aalborg, Denmark
| | - Marianne Tang Severinsen
- Department of Haematology, Clinical Cancer Research Unit, Aalborg University Hospital, Mølleparkvej 4, 9000, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Henrik Frederiksen
- Department of Haematology, Odense University Hospital, Odense, Denmark
- Odense University Hospital, Academy of Geriatric Cancer Research (AgeCare), Odense, Denmark
| | - Carsten Utoft Niemann
- Department of Haematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Peter Brown
- Department of Haematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Eldad J Dann
- Department of Haematology, Rambam Medical Center, and Bruce Rappaport Faculty of Medicine, Technion University, Haifa, Israel
| | - Søren Paaske Johnsen
- Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University and Aalborg University Hospital, Aalborg, Denmark
| | - Tarec Christoffer El-Galaly
- Department of Haematology, Clinical Cancer Research Unit, Aalborg University Hospital, Mølleparkvej 4, 9000, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Department of Haematology, Odense University Hospital, Odense, Denmark
- Department of Medicine Solna, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden
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Wasifuddin M, Ilerhunmwuwa NP, Becerra H, Hakobyan N, Shrestha N, Uche IN, Lin H, Abowali H, Zheng J, Yadav R, Pokhrel A, Enayati L, Hare M, Hehr R, Kozii K, Gibadullin B, Avezbakiyev B, Wang JC. Racial disparities in the incidence and survival outcomes in diffuse large B-cell lymphoma in adolescents and young adults. Eur J Haematol 2024. [PMID: 38890006 DOI: 10.1111/ejh.14255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 05/25/2024] [Accepted: 06/04/2024] [Indexed: 06/20/2024]
Abstract
Diffuse large B-cell Lymphoma (DLBCL) is an aggressive subtype of non-Hodgkin lymphoma (NHL). The disease generally occurs in older patients. Although at a lower prevalence, the disease also occurs in the adolescent and young adult group (AYA). There is paucity of data in the literature on racial and ethnic disparities in the incidence and survival outcomes of DLBCL in the AYA group. The objective of our study is to demonstrate the disparities in these outcomes. Utilizing SEER, we obtained data on patient demographics, incidence, and survival from 2000 to 2020. We observed statistically significant reduced incidence of DLBCL in all racial groups, except the non-Hispanic Asian and Pacific Islander group (NHAPI). The non-Hispanic Black group (NHB) had one of the lowest survival despite showing the largest decrease in incidence in DLBCL. The differences in the survival could be secondary to socioeconomic factors, however other reasons need to be explored. The increased incidence among the NHAPI group mirrors that of large population-based studies in East Asian countries, however, underlying reasons have not been elucidated.
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Affiliation(s)
- Mustafa Wasifuddin
- Department of Medicine, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
| | | | - Henry Becerra
- Department of Medicine, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
| | - Narek Hakobyan
- Department of Medicine, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
| | - Neharika Shrestha
- Department of Medicine, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
| | - Ifeanyi Nnamdi Uche
- Department of Medicine, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
| | - Htet Lin
- Department of Medicine, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
| | - Hesham Abowali
- Division of Hematology/Oncology, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
| | - Jin Zheng
- Division of Hematology/Oncology, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
| | - Ruchi Yadav
- Division of Hematology/Oncology, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
| | - Akriti Pokhrel
- Division of Hematology/Oncology, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
| | - Ladan Enayati
- Division of Hematology/Oncology, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
| | - Mitchell Hare
- Department of Medicine, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
| | - Rohan Hehr
- Department of Medicine, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
| | - Khrystyna Kozii
- Department of Medicine, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
| | - Bulat Gibadullin
- Department of Medicine, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
| | - Boris Avezbakiyev
- Division of Hematology/Oncology, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
| | - Jen-Chin Wang
- Division of Hematology/Oncology, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
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Nze C. Barriers to accessing cellular therapy for patients receiving care in community practices. HEMATOLOGY. AMERICAN SOCIETY OF HEMATOLOGY. EDUCATION PROGRAM 2023; 2023:382-385. [PMID: 38066850 PMCID: PMC10727008 DOI: 10.1182/hematology.2023000518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Affiliation(s)
- Chijioke Nze
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
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