Racial differences in treatment and survival among older patients with multiple myeloma
Abstract Background Treatments for multiple myeloma (MM) have evolved over time and improved MM survival. While racial differences in MM treatment and prognosis between non‐Hispanic African American (NHAA) and non‐Hispanic White (NHW) patients are well‐established, it is unclear whether they have pe...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-02-01
|
| Series: | Cancer Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/cam4.6915 |
| _version_ | 1797216980868005888 |
|---|---|
| author | Rong Wang Natalia Neparidze Xiaomei Ma Graham A. Colditz Su‐Hsin Chang Shi‐Yi Wang |
| author_facet | Rong Wang Natalia Neparidze Xiaomei Ma Graham A. Colditz Su‐Hsin Chang Shi‐Yi Wang |
| author_sort | Rong Wang |
| collection | DOAJ |
| description | Abstract Background Treatments for multiple myeloma (MM) have evolved over time and improved MM survival. While racial differences in MM treatment and prognosis between non‐Hispanic African American (NHAA) and non‐Hispanic White (NHW) patients are well‐established, it is unclear whether they have persisted after the introduction of novel agents. Methods Using the Surveillance, Epidemiology, and End Results‐Medicare linked database, our study investigated racial difference in the receipt of treatment within 1 year following diagnosis and assessed survival outcomes among Medicare beneficiaries (≥66 years) diagnosed with MM from 2007 to 2017. We applied multivariable Cox proportional hazards models to estimate the association between race and survival and presented hazard ratios (HRs). Results Of 2094 NHAA and 11,983 NHW older patients with MM, 59.5% and 64.8% received treatment during the first year, respectively. Discrepancy in the proportion of patients receiving treatment between the two groups increased from 2.9% in 2007 to 2009 to 6.9% in 2014–2017. After controlling for relevant factors, patients who received treatment within the first year had lower mortality than those who did not (HR = 0.90, 95% confidence interval [CI]: 0.86–0.94). NHAA patients had a lower probability to receive treatments during the first year than NHW patients (HR = 0.91, 95% CI: 0.85–0.97) but had lower mortality (HR = 0.94, 95% CI: 0.88–1.00). The lower mortality was only observed among patients who received no treatment (HR = 0.84, 95% CI: 0.77–0.93); NHAA and NHW patients who received treatment had similar survival (p = 0.63). Conclusions The increasing racial disparity in treatment utilization over time is concerning. Efforts are needed to eliminate the barriers of receiving treatment. |
| first_indexed | 2024-03-07T15:43:41Z |
| format | Article |
| id | doaj.art-87bc042a6b2540c284746f08eea1e810 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-04-24T11:54:35Z |
| publishDate | 2024-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-87bc042a6b2540c284746f08eea1e8102024-04-09T05:45:47ZengWileyCancer Medicine2045-76342024-02-01133n/an/a10.1002/cam4.6915Racial differences in treatment and survival among older patients with multiple myelomaRong Wang0Natalia Neparidze1Xiaomei Ma2Graham A. Colditz3Su‐Hsin Chang4Shi‐Yi Wang5Department of Chronic Disease Epidemiology Yale School of Public Health New Haven Connecticut USACancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center Yale University New Haven Connecticut USADepartment of Chronic Disease Epidemiology Yale School of Public Health New Haven Connecticut USADepartment of Surgery, Division of Public Health Sciences Washington University School of Medicine St. Louis Missouri USADepartment of Surgery, Division of Public Health Sciences Washington University School of Medicine St. Louis Missouri USADepartment of Chronic Disease Epidemiology Yale School of Public Health New Haven Connecticut USAAbstract Background Treatments for multiple myeloma (MM) have evolved over time and improved MM survival. While racial differences in MM treatment and prognosis between non‐Hispanic African American (NHAA) and non‐Hispanic White (NHW) patients are well‐established, it is unclear whether they have persisted after the introduction of novel agents. Methods Using the Surveillance, Epidemiology, and End Results‐Medicare linked database, our study investigated racial difference in the receipt of treatment within 1 year following diagnosis and assessed survival outcomes among Medicare beneficiaries (≥66 years) diagnosed with MM from 2007 to 2017. We applied multivariable Cox proportional hazards models to estimate the association between race and survival and presented hazard ratios (HRs). Results Of 2094 NHAA and 11,983 NHW older patients with MM, 59.5% and 64.8% received treatment during the first year, respectively. Discrepancy in the proportion of patients receiving treatment between the two groups increased from 2.9% in 2007 to 2009 to 6.9% in 2014–2017. After controlling for relevant factors, patients who received treatment within the first year had lower mortality than those who did not (HR = 0.90, 95% confidence interval [CI]: 0.86–0.94). NHAA patients had a lower probability to receive treatments during the first year than NHW patients (HR = 0.91, 95% CI: 0.85–0.97) but had lower mortality (HR = 0.94, 95% CI: 0.88–1.00). The lower mortality was only observed among patients who received no treatment (HR = 0.84, 95% CI: 0.77–0.93); NHAA and NHW patients who received treatment had similar survival (p = 0.63). Conclusions The increasing racial disparity in treatment utilization over time is concerning. Efforts are needed to eliminate the barriers of receiving treatment.https://doi.org/10.1002/cam4.6915multiple myelomaracial disparitySEER‐Medicaresurvivaltreatment |
| spellingShingle | Rong Wang Natalia Neparidze Xiaomei Ma Graham A. Colditz Su‐Hsin Chang Shi‐Yi Wang Racial differences in treatment and survival among older patients with multiple myeloma Cancer Medicine multiple myeloma racial disparity SEER‐Medicare survival treatment |
| title | Racial differences in treatment and survival among older patients with multiple myeloma |
| title_full | Racial differences in treatment and survival among older patients with multiple myeloma |
| title_fullStr | Racial differences in treatment and survival among older patients with multiple myeloma |
| title_full_unstemmed | Racial differences in treatment and survival among older patients with multiple myeloma |
| title_short | Racial differences in treatment and survival among older patients with multiple myeloma |
| title_sort | racial differences in treatment and survival among older patients with multiple myeloma |
| topic | multiple myeloma racial disparity SEER‐Medicare survival treatment |
| url | https://doi.org/10.1002/cam4.6915 |
| work_keys_str_mv | AT rongwang racialdifferencesintreatmentandsurvivalamongolderpatientswithmultiplemyeloma AT natalianeparidze racialdifferencesintreatmentandsurvivalamongolderpatientswithmultiplemyeloma AT xiaomeima racialdifferencesintreatmentandsurvivalamongolderpatientswithmultiplemyeloma AT grahamacolditz racialdifferencesintreatmentandsurvivalamongolderpatientswithmultiplemyeloma AT suhsinchang racialdifferencesintreatmentandsurvivalamongolderpatientswithmultiplemyeloma AT shiyiwang racialdifferencesintreatmentandsurvivalamongolderpatientswithmultiplemyeloma |