TY - JOUR
T1 - Rural and urban patients with diffuse large B-cell and follicular lymphoma experience reduced overall survival
T2 - a National Cancer DataBase study
AU - Ritter, Andrew J.
AU - Goldstein, Jordan S.
AU - Ayers, Amy A.
AU - Flowers, Christopher R.
N1 - Publisher Copyright:
© 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2019/6/7
Y1 - 2019/6/7
N2 - We examined 83,108 patients with diffuse large B-cell lymphoma (DLBCL) and 43,393 patients with follicular lymphoma (FL) to investigate disparities related to geographic population density, stratified as rural, urban, or metropolitan. We found that urban and rural patients less commonly had private insurance and high socioeconomic status. Urban and rural DLBCL patients were more likely to receive treatment within 14 days of diagnosis (OR 0.93, 95% confidence interval [CI] 0.89–0.98; and OR 0.81, 95% CI 0.72–0.91) while urban FL patients were more likely to have treatment >14 days after diagnosis (OR 1.08, 95% CI 1.01–1.16). Multivariable analyses demonstrated that rural and urban patients had worse overall survival with DLBCL (hazard ratio [HR] 1.09; 95% CI 1–1.19 and HR 1.08; 95% CI 1.04–1.11) and FL (HR 1.11; 95% CI 1.04–1.18 and HR 1.2; 95% CI 1.02–1.41), respectively, suggesting needs for focused study and interventions for these populations.
AB - We examined 83,108 patients with diffuse large B-cell lymphoma (DLBCL) and 43,393 patients with follicular lymphoma (FL) to investigate disparities related to geographic population density, stratified as rural, urban, or metropolitan. We found that urban and rural patients less commonly had private insurance and high socioeconomic status. Urban and rural DLBCL patients were more likely to receive treatment within 14 days of diagnosis (OR 0.93, 95% confidence interval [CI] 0.89–0.98; and OR 0.81, 95% CI 0.72–0.91) while urban FL patients were more likely to have treatment >14 days after diagnosis (OR 1.08, 95% CI 1.01–1.16). Multivariable analyses demonstrated that rural and urban patients had worse overall survival with DLBCL (hazard ratio [HR] 1.09; 95% CI 1–1.19 and HR 1.08; 95% CI 1.04–1.11) and FL (HR 1.11; 95% CI 1.04–1.18 and HR 1.2; 95% CI 1.02–1.41), respectively, suggesting needs for focused study and interventions for these populations.
KW - Diffuse large B-cell lymphoma
KW - follicular lymphoma
KW - health disparities
KW - overall survival
KW - rural
KW - urban
UR - http://www.scopus.com/inward/record.url?scp=85068071487&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85068071487&partnerID=8YFLogxK
U2 - 10.1080/10428194.2018.1546855
DO - 10.1080/10428194.2018.1546855
M3 - Article
C2 - 30632824
AN - SCOPUS:85068071487
SN - 1042-8194
VL - 60
SP - 1656
EP - 1667
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 7
ER -