SOCIOECONOMIC STATUS IS GLOBALLY A PROGNOSTIC FACTOR FOR OVERALL SURVIVAL OF MULTIPLE MYELOMA PATIENTS; SYNTHESIS OF STUDIES AND REVIEW OF THE LITERATURE SES as prognostic factor for myeloma survival
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Keywords
myeloma, socioeconomic status
Abstract
Socioeconomic status (SES) is reflecting differences in sociodemographic factors affecting cancer survivorship. Deprived, low SES populations has a higher prevalence of multiple myeloma and worst survival, a gap that widens over time.
Methods: We performed a meta-analysis of 16 studies (registries and cohorts) reporting survival data of myeloma patients according to SES. Ten studies reported Hazzard Ratio (HR) (95 % CI) and 16 studies reported p values. We combined the HR from 10 studies and by using the Mosteller-Bush formula we performed the synthesis of p values according to the area of the globe.
Results: A combination of HR from 10 studies including 85198 myeloma patients weighted to sample size of each study and adopting the hypothesis of random effect returned a combined HR: 1,26 (1,13-1,31) in favor of high SES patients.
USA: Synthesis of p values coming from 6 studies (n=89807 pts) by using the Mosteller and Bush formula extracted a p-value of <0.0001 favoring high SES patients
Oceania: Synthesis of p values in two cohorts from Australia and New Zealand (n= 10196 pts) returned a p-value of 0,022 favoring high SES patients
Europe: The synthesis of p values from UK and Greece studies (n=18533 pts) returned a p-value of <0,0001 favoring high SES patients
Asia: Synthesis of 2 studies from Asia (n=915 pts) returned a p-value of <0,0001 favoring high SES patients
Conclusions: Across the globe and widening over decades socioeconomic status remains a gap for equality in myeloma care
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