Smith, Matthew James; Belot, Aurélien; Quartagno, Matteo; Luque Fernandez, Miguel Angel; Bonaventure, Audrey; Gachau, Susan; Benitez Majano, Sara; Rachet, Bernard; Njagi, Edmund Njeru; (2021) Excess Mortality by Multimorbidity, Socioeconomic, and Healthcare Factors, amongst Patients Diagnosed with Diffuse Large B-Cell or Follicular Lymphoma in England. Cancers, 13 (22). p. 5805. ISSN 2072-6694 DOI: https://doi.org/10.3390/cancers13225805
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Abstract
(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.
Item Type | Article |
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Faculty and Department |
Faculty of Public Health and Policy > Dept of Health Services Research and Policy Faculty of Epidemiology and Population Health > Dept of Non-Communicable Disease Epidemiology |
Research Centre | Inequalities in Cancer Outcomes Network |
PubMed ID | 34830964 |
Elements ID | 167393 |
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