Luciano Jose Costa, M.D., Ph.D.A new University of Alabama at Birmingham study reveals socioeconomic factors, not race or ethnicity, influence the survival of younger multiple myeloma patients.
Advances in treatment of multiple myeloma have led to improved survival, predominantly among young and white patients, with fewer benefits experienced by patients of other ethnicities.
A new UAB study published in Cancer, a peer-reviewed journal of the American Cancer Society, indicates this gap is due mostly to socioeconomic differences such as marital status, income and insurance status that directly and independently affect the chances of survival among younger multiple myeloma patients, not necessarily race or ethnic background.
Luciano Jose Costa, M.D., Ph.D., associate professor in the UAB Division of Hematology and Oncology, led a team that studied data of more than 10,000 multiple myeloma patients in the United States who were under the age of 65.
“When socioeconomic factors were accounted for, we found that race did not impact survival,” Costa said.
The UAB study is the largest and most complete to address the impact of socio-demographic factors on survival of myeloma patients under the age of 65.
Multiple myeloma, a cancer that forms in a type of white blood cell, is the second-most-common hematologic malignancy in the United States, with 30,300 new cases expected in 2016. Multiple myeloma is a rare cancer, and the mortality rate is high with only a five-year survival rate. It most frequently occurs in patients 65 or older; however, about 38 percent of new cases are age 65 or younger.
Although it has been known that black patients have had reduced improvement in outcomes compared to white patients, the researchers suspected it was more complex than that. They found that the four-year estimated survival was 71.1 percent, 63.2 percent, 53.4 percent and 46.5 percent for patients with zero, one, two or three adverse sociodemographic factors, respectively. For instance, a patient who is not married, lives in a low-income county and is a beneficiary of Medicare has a 25 percent lower chance of being alive in four years after diagnosis than a patient of the same age who is married and lives in a medium- to high-income county and has private insurance.
“Our findings strongly suggest there is a huge disparity in outcomes that could potentially be overcome by improving access and affordability of treatment,” said Costa, a scientist at the UAB Comprehensive Cancer Center. “With the recent emphasis on comparative effectiveness in oncology, it also becomes crucial that all variables affecting outcomes, including sociodemographic factors, are accounted for when comparisons between different therapeutic approaches and health care systems are made.”
The bottom line, according to Costa, is that “these potentially avoidable determinants indicate new opportunities for improving outcomes for multiple myeloma patients.”