RT Journal Article
T1 Excess Mortality by Multimorbidity, Socioeconomic, and Healthcare Factors, amongst Patients Diagnosed with Diffuse Large B-Cell or Follicular Lymphoma in England.
A1 Smith, Matthew James
A1 Belot, Aurélien
A1 Quartagno, Matteo
A1 Luque Fernandez, Miguel Angel
A1 Bonaventure, Audrey
A1 Gachau, Susan
A1 Benitez Majano, Sara
A1 Rachet, Bernard
A1 Njagi, Edmund Njeru
K1 cancer epidemiology
K1 comorbidity
K1 diffuse large B-cell lymphoma
K1 follicular lymphoma
K1 multimorbidity
K1 socioeconomic status
K1 survival analysis
AB (1) Background: Socioeconomic inequalities of survival in patients with lymphoma persist, which may be explained by patients' comorbidities. We aimed to assess the association between comorbidities and the survival of patients diagnosed with diffuse large B-cell (DLBCL) or follicular lymphoma (FL) in England accounting for other socio-demographic characteristics. (2) Methods: Population-based cancer registry data were linked to Hospital Episode Statistics. We used a flexible multilevel excess hazard model to estimate excess mortality and net survival by patient's comorbidity status, adjusted for sociodemographic, economic, and healthcare factors, and accounting for the patient's area of residence. We used the latent normal joint modelling multiple imputation approach for missing data. (3) Results: Overall, 15,516 and 29,898 patients were diagnosed with FL and DLBCL in England between 2005 and 2013, respectively. Amongst DLBCL and FL patients, respectively, those in the most deprived areas showed 1.22 (95% confidence interval (CI): 1.18-1.27) and 1.45 (95% CI: 1.30-1.62) times higher excess mortality hazard compared to those in the least deprived areas, adjusted for comorbidity status, age at diagnosis, sex, ethnicity, and route to diagnosis. (4) Conclusions: Deprivation is consistently associated with poorer survival among patients diagnosed with DLBCL or FL, after adjusting for co/multimorbidities. Comorbidities and multimorbidities need to be considered when planning public health interventions targeting haematological malignancies in England.
SN 2072-6694
YR 2021
FD 2021-11-19
LK https://hdl.handle.net/10668/24679
UL https://hdl.handle.net/10668/24679
LA en
DS RISalud
RD Apr 12, 2025