a Emory University School of Medicine , Atlanta , GA , USA.
b Winship Cancer Institute , Atlanta , GA , USA.
Leuk Lymphoma. 2019 Jul;60(7):1656-1667. doi: 10.1080/10428194.2018.1546855. Epub 2019 Jan 11.
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.
我们研究了 83108 例弥漫性大 B 细胞淋巴瘤 (DLBCL) 患者和 43393 例滤泡淋巴瘤 (FL) 患者，以调查与地理人口密度相关的差异，分为农村、城市或都会。我们发现，城市和农村患者较少拥有私人保险和高社会经济地位。城市和农村 DLBCL 患者更有可能在诊断后 14 天内接受治疗（OR 0.93，95%CI 0.89-0.98；和 OR 0.81，95%CI 0.72-0.91），而城市 FL 患者更有可能在诊断后 14 天以上接受治疗（OR 1.08，95%CI 1.01-1.16）。多变量分析表明，农村和城市患者的 DLBCL（HR 1.09；95%CI 1-1.19 和 HR 1.08；95%CI 1.04-1.11）和 FL（HR 1.11；95%CI 1.04-1.18 和 HR 1.2；95%CI 1.02-1.41）的总体生存率较差，这表明需要对这些人群进行重点研究和干预。
