US trends in survival disparities among adolescents and young adults with non-Hodgkin lymphoma
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Improvement in US survival rates among adolescents and young adults (AYAs, ages 15 through 39 years inclusive) diagnosed with non-Hodgkin lymphoma (NHL) has been documented over the last two decades. We examined national trends in survival disparities for AYAs with NHL by race/ethnicity and socioeconomic status (SES, county-level poverty) to further understand NHL and to begin monitoring health outcome disparities for this disease.
Surveillance Epidemiology and End Results data were used to calculate 5-year relative survival rates of AYAs diagnosed with NHL from 1992 to 2007 and followed through 2011. Absolute and relative disparities were computed using HD*Calc. Whether a significant linear trend was present was evaluated using Joinpoint. Analyses were replicated after excluding individuals with known HIV infection.
The study sample included 9,573 total and 7,121 non-HIV cases of NHL. Five-year survival rates improved for all groups over time. Significant decreases were found in absolute disparities for race/ethnicity (non-HIV), in relative disparities for SES (total) and race/ethnicity (total and non-HIV) (all p < 0.05). Survival rates of non-Hispanic Blacks and Hispanics remained below than those of non-Hispanic Whites throughout the time period.
Absolute and relative disparities in 5-year survival narrowed for AYAs with NHL over the time period. To continue to promote this trend, future research should investigate factors, particularly diagnostic delays and barriers to care, which continue to contribute to SES and racial/ethnic differences in survival. These factors may be particularly relevant to identify given the recent Affordable Care Act, which is designed to increase access to medical services, particularly for young adults.
KeywordsNon-Hodgkin lymphoma Adolescents and young adults Relative survival Cancer health disparities Surveillance
- 1.Adolescent and Young Adult Oncology Progress Review Group (2006) Closing the gap: research and care imperatives for adolescents and young adults with cancer (NIH Publication No. 06-6067). Bethesda, MDGoogle Scholar
- 5.Kato I, Booza J, Quarshie WO, Schwartz K (2012) Persistent socioeconomic inequalities in cancer survival in the United States: 1973–2007 Surveillance, Epidemiology and End Results (SEER) data for breast cancer and non-Hodgkin’s lymphoma. J Regist Manag 39:158–166Google Scholar
- 6.Kent EE, Morris RA, Largent JA, Ziogas A, Sender LS, Anton-Culver H (2010) Socioeconomic impacts on survival differ by race/ethnicity among adolescents and young adults with non-Hodgkin’s lymphoma. J Cancer EpidemiolGoogle Scholar
- 10.Harper S, Lynch J, Meersman SC, Breen N, Davis WW, Reichman MC (2009) Trends in area-socioeconomic and race–ethnic disparities in breast cancer incidence, stage at diagnosis, screening, mortality, and survival among women ages 50 years and over (1987–2005). Cancer Epidemiol Biomark Prev 18:121–131CrossRefGoogle Scholar
- 13.Fritz A, Percy C, Jack A et al (2000) International classification of diseases for oncology (ICD-O), 3rd edn. World Health Organization, GenevaGoogle Scholar
- 14.NAACCR Race and Ethnicity Work Group (2011) NAACCR guideline for enhancing Hispanic/Latino identification: revised NAACCR Hispanic/Latino identification algorithm [NHIA v2.2.1]. North American Association of Central Cancer Registries, Springfield, ILGoogle Scholar
- 15.Cho H, Howlader N, Mariotto AB, Cronin KA (2011) Estimating relative survival for cancer patients from the SEER Program using expected rates based on Ederer I versus Ederer II method. Surveillance Research Program, National Cancer Institute, Bethesda, MD Google Scholar
- 16.Health Disparities Calculator Version 1.2.4—October 29 2013. Division of Cancer Control and Population Sciences, Surveillance Research Program and Applied Research Program, National Cancer InstituteGoogle Scholar
- 17.Harper S, Lynch J (2005) Methods for measuring cancer disparities: using data relevant to Healthy People 2010 cancer-related objectives. NCI Cancer Surveillance Monograph Series. National Cancer Institute, Bethesda, MDGoogle Scholar
- 18.Harper S, Lynch J (2005) Selected comparisons of measures of health disparities: a review using databases relevant to Healthy People 2010 cancer-related objectives. National Cancer Institute, Bethesda, MDGoogle Scholar
- 19.Surveillance E, and End Results (SEER) Program (www.seer.cancer.gov). SEER*Stat Database: Incidence—SEER 18 Regs Research Data, Nov 2011 Sub (1973–2010) <Katrina/Rita Population Adjustment>—Linked To County Attributes—Total U.S., 1969–2010 Counties, National Cancer Institute, DCCPS, Surveillance Research Program, Surveillance Systems Branch, released April 2013, based on the November 2012 submission
- 20.Statistical Methodology and Applications Branch SRP, National Cancer Institute. Joinpoint Regression Program, Version 4.0.4—May 2013Google Scholar
- 25.Sandlund JT (2007) Should adolescents with NHL be treated as old children or young adults? Hematology/the Education Program of the American Society of Hematology. American Society of Hematology. Education Program, pp 297–303Google Scholar
- 28.Bruce CJ (2007) Rituxan® anniversary: 10 years of progress. Oncol Bus Rev (November):18–19 Google Scholar
- 33.Levit L, Balogh E, Nass S, Ganz PA (2013) Delivering high-quality cancer care: charting a new course for a system in crisis. The National Academies Press, Washington, DCGoogle Scholar
- 37.Aizer AA, Falit B, Mendu ML et al (2014) Cancer-specific outcomes among young adults without health insurance. J Clin Oncol 32:2025–2030Google Scholar
- 38.Pew Hispanic Center (2011) Census 2010: 50 million Latinos: Hispanics account for more than half of the nation’s growth in past decade. Pew Research CenterGoogle Scholar