Intzes Stergios, Symeonidou Marianthi, Zagoridis Konstantinos, Bezirgianidou Zoe, Vrachiolias Georgios, Spanoudaki Athina, Spanoudakis Emmanouil
Democritus University of Thrace, Medical School, Department of Hematology. Alexandroupolis, Greece.
Mediterr J Hematol Infect Dis. 2021 Jan 1;13(1):e2021006. doi: 10.4084/MJHID.2021.006. eCollection 2021.
Socioeconomic status (SES) is reflecting differences in sociodemographic factors affecting cancer survivorship. Deprived, low SES populations have a higher prevalence of multiple myeloma and worst survival, a condition which widens over time.
We performed a meta-analysis of 16 studies (registries and cohorts) reporting myeloma patients' survival data according to SES. Ten studies reported Hazzard Ratio (H.R.) (95 % CI), and 16 studies reported p values. We combined the H.R. from 10 studies, and by using the Mosteller-Bush formula, we performed a synthesis of p values according to the area of the globe.
Combination of H.R. from 10 studies including 85198 myeloma patients weighted to sample size of each study and adopting the hypothesis of random effect returned a combined H.R.: 1,26 (1,13-1,31) in favor of high SES patients.USA: Synthesis of p values coming from 6 studies (n=89807 pts) by using the Mosteller and Bush formula extracted a p-value of <0.0001 favoring high SES patients.Oceania: Synthesis of p values in two cohorts from Australia and New Zealand (n= 10196 pts) returned a p-value of 0,022 favoring high SES patients.Europe: The synthesis of p values from the U.K. and Greece studies (n=18533 pts) returned a p-value of <0,0001 favoring high SES patients.Asia: Synthesis of 2 studies from Asia (n=915 pts) returned a p-value of <0,0001 favoring high SES patients.
Across the globe and widening over decades, the socioeconomic status remains a gap for equality in myeloma care.
社会经济地位（SES）反映了影响癌症生存的社会人口因素差异。贫困的低社会经济地位人群多发性骨髓瘤患病率较高且生存率最差，这种情况会随着时间推移而扩大。
我们对16项研究（登记处和队列研究）进行了荟萃分析，这些研究报告了根据社会经济地位划分的骨髓瘤患者生存数据。10项研究报告了风险比（H.R.）（95%置信区间），16项研究报告了p值。我们合并了10项研究的H.R.，并使用莫斯特勒 - 布什公式，根据全球区域对p值进行了综合分析。
包括85198例骨髓瘤患者的10项研究的H.R.合并，根据每项研究的样本量加权，并采用随机效应假设，得出合并H.R.：1.26（1.13 - 1.31），有利于高社会经济地位患者。美国：使用莫斯特勒和布什公式对6项研究（n = 89807例患者）的p值进行综合分析，得出p值<0.0001，有利于高社会经济地位患者。大洋洲：对澳大利亚和新西兰的两个队列（n = 10196例患者）的p值进行综合分析，得出p值为0.022，有利于高社会经济地位患者。欧洲：对英国和希腊研究（n = 18533例患者）的p值进行综合分析，得出p值<0.0001，有利于高社会经济地位患者。亚洲：对亚洲的2项研究（n = 915例患者）的p值进行综合分析，得出p值<0.0001，有利于高社会经济地位患者。
在全球范围内且数十年来差距不断扩大，社会经济地位仍然是骨髓瘤治疗平等方面的一个差距。
