High combined individual and neighborhood socioeconomic status correlated with better survival of patients with lymphoma in post-rituximab era despite universal health coverage

Abstract

The correlation between high socioeconomic status (SES) and better survival outcome in patients with either Hodgkin lymphoma (HL) or non-Hodgkin lymphoma (NHL) was well-established in the pre-rituximab era. However, whether or not such an association exists in the post-retuxamib era has not been reliably demonstrated. Herein we conducted a population-based study in Taiwan involving 5010 patients diagnosed between 2002 and 2006 to investigate the relationship between individual and neighborhood SES and survival outcomes for lymphoma. A proxy measure of individual SES is based on income-related insurance payment, and neighborhood SES is based on neighborhood household income. After adjusting for patient characteristics, treatment modalities, and hospital characteristics, HL patients with high individual SES in advantaged neighborhoods showed a decreased risk of mortality (HR 0.33, 95%, CI 0.10–0.99). NHL patients with high individual SES in advantaged neighborhoods showed a moderate decreased risk of death (HR 0.62; 95% CI 0.51–0.75), compared to those with low SES in disadvantaged neighborhoods. In the future, public health strategies and welfare policies must continue to focus on this vulnerable group.

Keywords

• Lymphoma
• Survival rate
• Socioeconomic status
• Neighborhood
• Taiwan