2628:社会经济地位对多发性骨髓瘤癌症特异性生存影响的种族差异

Huiwen Deng, A. Zolekar, Hsiao-Ching Huang, M. Smart, C. Hubbard, B. Chiu, P. Patel, K. Sweiss, G. Calip
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引用次数: 0

摘要

背景:美国不同种族/民族的多发性骨髓瘤(MM)发病率和预后不同。社会经济地位(SES)与种族在MM发病率和生存结局中的相互作用尚不清楚。我们的目的是评估不同种族/民族诊断为MM的患者癌症特异性生存率的差异。方法:利用监测、流行病学和最终结果、人口普查区水平SES和农村数据库,对2000年至2015年间诊断为MM的20岁以上患者进行了基于人群的回顾性队列研究。SES的定义采用Yost等人(2001)开发的美国国家癌症研究所时间依赖综合评分。Yost指数五分位数是指第1和第5五分位数分别代表最低和最高的SES类别。使用累积发生率函数分析不同阶层、种族/民族和社会经济地位的癌症特异性生存率,并使用Gray9s检验确定函数的平等性。使用Fine和Gray回归模型计算亚分布风险比(SHR)和95%置信区间(CI),调整年龄、性别、诊断年份、婚姻状况、保险状况和化疗治疗情况。种族特异性风险估计按年龄分层(结果:总体而言,58,095例MM患者纳入我们的分析,其中63.0%为非西班牙裔白人,19.5%为黑人,0.3%为美洲印第安人/阿拉斯加原住民,5.8%为亚洲/太平洋岛民,11.4%为西班牙裔。与白人MM患者(中位年龄69岁)相比,黑人(64岁)、美洲印第安人/阿拉斯加原住民(64岁)、亚洲/太平洋岛民(67岁)和西班牙裔(64岁)患者的平均年龄更小。黑人(42.8%)和西班牙裔(27.9%)MM患者的最低SES五分位数比例高于白人(10.6%)、美洲印第安人/阿拉斯加原住民(15.2%)和亚洲/太平洋岛民(8.9%)MM患者。不同社会经济水平的癌症特异性生存的累积发生率函数有显著差异(P)。结论:低社会经济水平与较差的mm特异性生存独立相关。然而,SES对mm特异性生存的影响因种族/民族和年龄而异,在年轻的黑人、西班牙裔和白人患者中观察到的风险增加最大。引用格式:邓慧文,Ashwini Zolekar,黄晓青,Mary H. Smart, Colin C. Hubbard, Brian C. Chiu, Pritesh R. Patel, Karen Sweiss, Gregory S. Calip。社会经济地位对多发性骨髓瘤癌症特异性生存影响的种族差异[摘要]。见:美国癌症研究协会2021年年会论文集;2021年4月10日至15日和5月17日至21日。费城(PA): AACR;癌症杂志,2021;81(13 -增刊):2628。
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Abstract 2628: Racial differences in the impact of socioeconomic status on cancer-specific survival in multiple myeloma
Background: Multiple myeloma (MM) incidence and outcomes differ across racial/ethnic groups in the United States. Interactions between socioeconomic status (SES) with ethnicity in MM incidence and survival outcomes are not well understood. Our objective was to evaluate disparities in cancer-specific survival of patients diagnosed with MM by race/ethnicity. Methods: We conducted a population-based retrospective cohort study of patients ages 20+ years diagnosed with MM between 2000 and 2015 using Surveillance, Epidemiology and End Results, Census Tract-level SES and Rurality Database. SES was defined using the National Cancer Institute9s time-dependent composite score developed by Yost et al. (2001). Yost index quintiles were where the 1st and 5th quintiles representing the lowest and highest SES categories respectively. Cumulative incidence functions were used to analyze cancer-specific survival across strata racial/ethnic and SES and equality of functions was determined using Gray9s test. Subdistribution hazard ratios (SHR) and 95% confidence intervals (CI) were calculated using the Fine and Gray regression models adjusted for age, sex, year of diagnosis, marital status, insurance status, and treatment with chemotherapy. Race-specific risk estimates were stratified by age ( Results: Overall, 58,095 MM patients were included in our analysis among whom 63.0% were non-Hispanic White, 19.5% were Black, 0.3% were American Indian/Alaskan Native, 5.8% were Asian/Pacific Islander and 11.4% were Hispanic. Compared to White MM patients (median age 69 years), Black (64 years), American Indian/Alaskan Native (64 years), Asian/Pacific Islander (67 years) and Hispanic (64 years) patients were younger on average. A higher proportion of Black (42.8%) and Hispanic (27.9%) MM patients were in the lowest SES quintile compared to White (10.6%), American Indian/Alaskan Native (15.2%), and Asian/Pacific Islander (8.9%) MM patients. Cumulative incidence functions for cancer-specific survival were significantly different across SES quintiles (P Conclusion: Low SES level is independently associated with poor MM-specific survival. However, the impacts of SES on MM-specific survival differ by race/ethnicity and age with the greatest increased risk observed in younger Black, Hispanic, and White patients. Citation Format: Huiwen Deng, Ashwini Zolekar, Hsiao-Ching Huang, Mary H. Smart, Colin C. Hubbard, Brian C. Chiu, Pritesh R. Patel, Karen Sweiss, Gregory S. Calip. Racial differences in the impact of socioeconomic status on cancer-specific survival in multiple myeloma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 2628.
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