美国 SEER 人群中多发性骨髓瘤患者的生存差异与邻里社会经济地位和种族/民族有关。
Differences in survival among multiple myeloma patients in the United States SEER population by neighborhood socioeconomic status and race/ethnicity.
机构信息
Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Road North, Worcester, MA, 01655, USA.
Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA.
出版信息
Cancer Causes Control. 2021 Sep;32(9):1021-1028. doi: 10.1007/s10552-021-01454-w. Epub 2021 Jun 5.
PURPOSE
We examined the combined influences of race/ethnicity and neighborhood socioeconomic status (SES) on long-term survival among patients with multiple myeloma (MM).
METHODS
Data from the 2000-2015 NCI Surveillance, Epidemiology, and End Results Program (SEER-18) were used. Census tract-level SES index was assessed in tertiles (low, medium, high SES). Competing-risk modeling was used to estimate sub-hazard ratios (SHR) and 95% confidence intervals (CIs) for SES tertile adjusted for sex and age at diagnosis and stratified by race/ethnicity.
RESULTS
Overall, living in a low SES neighborhood was associated with worse MM survival. However, we observed some variation in the association by racial/ethnic group. Living in a low versus a high SES neighborhood was associated with a 35% (95% CI = 1.16-1.57) increase in MM-specific mortality risk among Asian/Pacific Islander cases, a 17% (95% CI = 1.12-1.22) increase among White cases, a 14% (95% CI = 1.04-1.23) increase among Black cases, and a 7% (95% CI = 0.96-1.19) increase among Hispanic cases.
CONCLUSION
These results suggest that the influence of both SES and race/ethnicity should be considered when considering interventions to remedy disparities in MM survival.
目的
我们研究了种族/民族和社区社会经济地位（SES）对多发性骨髓瘤（MM）患者长期生存的综合影响。
方法
使用了 2000-2015 年 NCI 监测、流行病学和最终结果计划（SEER-18）的数据。采用三分位法（低、中、高 SES）评估了普查地段水平的 SES 指数。竞争风险模型用于估计 SES 三分位调整后的亚危险比（SHR）和 95%置信区间（CI），并按种族/民族分层，按诊断时的性别和年龄进行调整。
结果
总体而言，居住在 SES 较低的社区与 MM 生存较差有关。然而，我们观察到种族/民族群体之间的关联存在一些差异。与居住在 SES 较高的社区相比，居住在 SES 较低的社区与亚裔/太平洋岛民病例的 MM 特异性死亡率风险增加 35%（95%CI=1.16-1.57）、白种人病例增加 17%（95%CI=1.12-1.22）、黑种人病例增加 14%（95%CI=1.04-1.23）和西班牙裔病例增加 7%（95%CI=0.96-1.19）。
结论
这些结果表明，在考虑干预措施以纠正 MM 生存差异时，应考虑 SES 和种族/民族的双重影响。
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