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. 2012 Feb 28;106(5):988-95.
doi: 10.1038/bjc.2012.3. Epub 2012 Feb 7.

Socioeconomic position, treatment, and survival of non-Hodgkin lymphoma in Denmark--a nationwide study

B L Frederiksen  1 , S O Dalton, M Osler, M Steding-Jessen, P de Nully Brown
Affiliations

Socioeconomic position, treatment, and survival of non-Hodgkin lymphoma in Denmark--a nationwide study

B L Frederiksen et al. Br J Cancer. .

Abstract

Background: Not all patients have benefited equally from the advances in non-Hodgkin lymphoma (NHL) survival. This study investigates several individual-level markers of socioeconomic position (SEP) in relation to NHL survival, and explores whether any social differences could be attributed to comorbidity, disease and prognostic factors, or the treatment given.

Methods: This registry-based cohort study links clinical data on prognostic factors and treatment from the national Danish lymphoma database to individual socioeconomic information in Statistics Denmark including 6234 patients diagnosed with NHL in 2000-2008.

Results: All-cause mortality was 40% higher in NHL patients with short vs higher education diagnosed in the period 2000-2004 (hazard ratio (HR)=1.40 (1.27-1.54)), and 63% higher in the period 2005-2008 (HR=1.63 (1.40-1.90)). Further, mortality was increased in unemployed and disability pensioners, those with low income, and singles. Clinical prognostic factors attenuated, but did not eliminate the association between education and mortality. Radiotherapy was less frequently given to those with a short education (odds ratio (OR)= 0.84 (0.77-0.92)), low income (OR=0.80 (0.70-0.91)), and less frequent to singles (OR=0.79 (0.64-0.96)). Patients living alone were less likely to receive all treatment modalities.

Conclusion: Patients with low SEP have an elevated mortality rate after a NHL diagnosis, and more advanced disease at the time of diagnosis explained a part of this disparity. Thus, socioeconomic disparities in NHL survival might be reduced by improving early detection among patients of low SEP.

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Figures

Figure 1
Figure 1
Kaplan–Meier survival curves (N=6234) by level of education.
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References

    1. Auvinen A (1992) Social class and colon cancer survival in Finland. Cancer 70(2): 402–409 - PubMed
    1. Baadsgaard M, Quitzau J (2011) Danish registers on personal income and transfer payments. Scand J Public Health 39(Suppl 7): 103–105 - PubMed
    1. Bray C, Morrison DS, McKay P (2008) Socio-economic deprivation and survival of non-Hodgkin lymphoma in Scotland. Leuk Lymphoma 49(5): 917–923 - PubMed
    1. Byers TE, Wolf HJ, Bauer KR, Bolick-Aldrich S, Chen VW, Finch JL, Fulton JP, Schymura MJ, Shen T, Van HS, Yin X (2008) The impact of socioeconomic status on survival after cancer in the United States: findings from the National Program of Cancer Registries Patterns of Care Study. Cancer 113(3): 582–591 - PubMed
    1. Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40(5): 373–383 - PubMed