PGY-2 Oncology Pharmacy Resident Yale New Haven Health New Haven, Connecticut, United States
Poster Abstract: Lymphoma is the seventh most frequent cancer diagnosis in the world, however, the epidemiology of non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL) vary between geographic regions. In the United States, various studies have shown that the disease characteristics, incidence, and survival of lymphomas for certain racial and socioeconomic groups are different from others. While recent therapeutic advancements have improved our ability to treat patients with many lymphoma subtypes, health disparities exist. Health disparities involve complex associations between social, environmental, biologic, and patient-centered factors that may help explain differences in lymphoma outcomes in vulnerable patient populations. In an analysis of the SEER Database (2007-2015) of survival among NHL patients, blacks had the worst survival and patients on private insurance had better survival compared to those with public insurance. Black patients with diffuse large B cell lymphoma have a risk of death that is 10% to 20% higher than the non-Hispanic white population in numerous studies, with survival differences persisting after the introduction of rituximab. Despite efforts for increased health coverage for all, minorities remain more likely to be uninsured compared to white patients, leading to disparities in access to high-quality healthcare.
The primary objectives are to analyze the impact of healthcare disparities on survival and response rate for lymphoma patients and identify barriers to appropriate care at Smilow Cancer Hospital at Yale New Haven Health (YNNH). Secondary objectives include rates of treatment delays, dose reductions, completion of planned curative treatment, and analysis of deviation from standard treatment.
A retrospective single-centered chart review was performed on eligible patients treated at Yale New Haven Health System (YNHHS) from 8/1/2013 - 8/30/2023. Eligible patients aged ≥ 18 years with lymphoma (B-cell or T cell) were included. Patients were excluded if they had another malignancy other than lymphoma, were diagnosed prior to 2013, were on chemotherapy for palliative intent and/or if they had an ECOG ≥ 4. Data points for collection include race, gender identity, social history, barriers to adherence (e.g. transportation issues and complications related to treatment), insurance status (e.g. private, Medicare, Medicaid, uninsured), 5-year overall survival, time from symptom onset to diagnosis, time from diagnosis to first cycle of chemotherapy and time from diagnosis to death or disease progression.
Results will be presented at HOPA’s annual conference pending final statistical analyses.
Conclusions will be presented at HOPA’s annual conference pending final statistical analyses.
References (must also be included in final poster): 1. Phillips AA, Smith DA. Health disparities and the global landscape of lymphoma care today. American Society of Clinical Oncology Educational Book. 2017;(37):526-534.
2. Abodunrin FO, Akinyemi OA, Ojo AS, et al. Racial disparities in survival among non-hodgkin lymphoma patients: an analysis of the seer database(2007-2015). Cureus. 2022;14(6):e25867.
3. Wang M, Burau KD, Fang S, et al. Ethnic variations in diagnosis, treatment, socioeconomic status, and survival in a large population-based cohort of elderly patients with non-Hodgkin lymphoma. Cancer. 2008;113:3231-3241.
4. Flowers CR, Nastoupil LJ. Socioeconomic disparities in lymphoma. Blood. 2014;123(23):3530-3531.
5. Hill L, Ndugga N, Published SA. Key data on health and health care by race and ethnicity. KFF.
