Newswise — A retrospective study of more than 13,000 seniors with non-Hodgkin lymphoma (NHL) found that patients on the lower end of the economic ladder were more likely to die, report epidemiologists at The University of Texas School of Public Health. The study results will be published in the Dec. 1 issue of Cancer, a peer-reviewed journal of the American Cancer Society. NHL is a type of cancer that attacks the body's immune system.

"The seniors in the study in the bottom socioeconomic status quartile were 18 percent more likely to die of non-Hodgkin lymphoma than people in the top quartile," said Xianglin Du, M.D., Ph.D., the study's senior author and associate professor at the UT School of Public Health. The study also found that patients who received chemotherapy had better outcomes.

Du and his colleagues found no differences between the mortality risks of African-American and Caucasian patients when socioeconomic status, type of treatment and stage of illness were taken into account. "The widely-publicized disparities in survival outcomes in cancer in general between African-Americans and Caucasians disappear when you adjust for these factors," he said.

However, the study found that elderly Caucasian NHL patients were more likely to receive chemotherapy than African-American patients and there were a larger proportion of African-American patients living in poor communities compared with other ethnicities.

"This landmark study shows that fewer elderly African Americans received treatment for NHL and more African- American subjects were from lower socioeconomic groups. I suspect that similar to other cancers, barriers to treatment included costs, lack of knowledge about cancer and/or cultural beliefs. Although data on functional status could have provided further insight into the findings, this study suggests that a need for increased access to care and patient education still exists," said Carmel Bitondo Dyer, M.D., Roy M. and Phyllis Gough Huffington Chair in Gerontology at The University of Texas Medical School at Houston and head of Geriatric and Palliative Medicine at Memorial Hermann " Texas Medical Center and Lyndon B. Johnson General Hospital.

Non-Hodgkin lymphoma is a common cancer in the elderly population, with a median age at diagnosis of 67 years, according to the National Cancer Institute and the American Cancer Society. It is estimated that more than 63,000 men and women will be diagnosed with NHL each year, and approximately 18,660 men and women will die of NHL with a median age at death of 74 years in the United States.

Michael Wang, M.D., assistant professor of the Department of Lymphoma and Myeloma of The University of Texas M. D. Anderson Cancer Center, was the lead author on the study titled "Ethnic Variations in Diagnosis, Treatment, Socioeconomic Status and Survival in a Large Population-Based Cohort of Elderly Patients with Non-Hodgkin Lymphoma."

Researchers analyzed SEER (Surveillance, Epidemiology and End Results) Medicare-linked data for 13,321 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.

They reviewed 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.

Du's collaborators from the UT School of Public Health include: Keith Burau, Ph.D., associate professor of biostatistics; and Shenying Fang, a Ph.D. graduate assistant in the Division of Epidemiology. Haijun (Harry) Wang, Ph.D., of the Department of Family and Community Medicine at the Baylor College of Medicine, also contributed.

Du's work is supported in part by a grant from the Agency for Healthcare Research and Quality.

MEDIA CONTACT
Register for reporter access to contact details
CITATIONS

Cancer, a peer-reviewed journal of the American Cancer Society (1-Dec-2008)