e23109 Background: Overall survival (OS) in non-Hodgkin lymphoma (NHL) has improved with therapeutic advances. Whether these improvements have occurred uniformly across lymphoma subtypes and sociodemographic groups remains uncertain. We evaluated temporal changes in 5-year OS and examined associations of race/ethnicity and socioeconomic factors with outcomes in indolent and aggressive NHL. Methods: Using Surveillance, Epidemiology and End Results (SEER) 21-registry data, we identified adults diagnosed with NHL from 2000–2017 (N = 108, 041) and grouped them into two eras (2000–2010 vs 2011–2017). OS was censored at 60 months. Kaplan–Meier methods estimated 5-year OS by era and subtype, with comparisons by log-rank testing. Multivariable Cox proportional hazards models were fitted separately for indolent and aggressive NHL, adjusting for age, sex, race/ethnicity, era, median household income (per 10, 000 increase) and living area (urban/rural). Statistical significance was set at p < 0. 05. Results: In Kaplan–Meier analyses of all NHL, 5-year OS was higher for patients diagnosed in 2011–2017 than in 2000–2010 (64. 7% vs 56. 6%, p < 0. 001). Subtype-specific analyses showed similar trends in both indolent (73. 8% vs 64. 6%, p < 0. 001) and aggressive NHL (54. 7% vs 47. 0%, p < 0. 001). Multivariable modeling in indolent NHL indicated that older age was associated with higher mortality (hazard ratio HR 1. 05 per year; 95% CI, 1. 049–1. 052; p < 0. 001), while female sex was associated with improved survival (HR 0. 68; 95% CI, 0. 66–0. 70; p < 0. 001). Compared with White patients, mortality was higher among Black (HR 1. 51; 95% CI, 1. 43–1. 60; p < 0. 001), Hispanic (HR 1. 21; 95% CI, 1. 15–1. 27; p < 0. 001), and Asian/Pacific Islander (HR 1. 11; 95% CI, 1. 04–1. 19; p = 0. 004) patients. Diagnosis in 2011–2017 (HR 0. 69; 95% CI, 0. 67-0. 71; p < 0. 001) and higher income (HR 0. 95 per 10, 000; 95% CI, 0. 937-0. 953; p < 0. 001) were independently associated with lower mortality. In aggressive NHL, increasing age (HR 1. 03 per year; 95% CI, 1. 032–1. 034; p < 0. 001) was associated with higher mortality. Compared with White patients, mortality was higher among Black (HR 1. 62; 95% CI, 1. 56–1. 69; p < 0. 001), Hispanic (HR 1. 18; 95% CI, 1. 13–1. 22; p < 0. 001), and Asian/Pacific Islander patients (HR 1. 11; 95% CI, 1. 06–1. 17; p < 0. 001). Female sex (HR 0. 79; 95% CI, 0. 77–0. 81; p < 0. 001), diagnosis in 2011–2017 (HR 0. 76; 95% CI, 0. 74–0. 78; p < 0. 001) and higher income (HR 0. 96 per 10, 000 increase; 95% CI, 0. 95–0. 97; p < 0. 001) were associated with improved survival. Living area was not associated with OS in either subtype. Conclusions: Five-year OS for both indolent and aggressive NHL improved in the contemporary era; however, notable racial and socioeconomic disparities persist. Despite overall survival gains, minority racial groups and lower-income communities continue to experience higher mortality, emphasizing the need for strategies to address inequities in lymphoma care.
Vanegas et al. (Thu,) studied this question.