Abstract
Non-Hodgkin lymphoma (NHL) is one of the most common cancers in the United States. It is one of the leading causes of cancer-specific morbidity and mortality. An explanation for the significant racial/ethnicity disparity in survival among NHL survivors has been attributed to disparity in access to treatment modalities. We determined if patients' race/ethnicity is an independent predictor of survival following a diagnosis of NHL. We utilized the SEER Registry to identify patients with a primary diagnosis of NHL from 2007 to 2015. Our primary outcome of interest was the patients' survival following a diagnosis of NHL. We determined cancer-specific survival at 1, 3, and 5 years stratified by patients' race/ethnicity. We used Cox regression to determine if the race/ethnicity disparity continues after controlling for disease stage, age, sex, and treatment modalities. There were 171,778 primary cases of NHL in the study period. The majority of the patients were Non-Hispanic Whites (NHW), 72.1%, Non-Hispanic Blacks (NHB), 7.8%, Hispanics, 12.0%, Non-Hispanic Asians, or Pacific Islanders (NHAPI), and 0.5% Non-Hispanic American Indians/Alaska Natives (NHAIAN). There were 54.9% males vs. 45.1% females. The mean age of the study population was 64.7± 16.6 years. Survival at 1, 3 and 5 years by patients' race/ethnicity was, NHW (90.3%, 84.0%, 81.2%), NHB (86.6%, 79.6%, 76.1%), Hispanics (87.4%, 81.5%, 78. 6%). NHB had the worst overall survival (OR=1.53; 95% CI 1.47-1.60), Hispanics (OR=1.23; 95% CI 1.19-1.28), NHAIP (1.26; 95% CI 1.20-1.32) and NHAIAN (OR=1.23; 95%CI 1.04-1.46). There is significant racial disparity in survival outcomes following NHL diagnosis. This disparity persisted even after controlling for patients' insurance type, disease stage, and treatment modalities. Further research is needed to unravel the role of genetics in the racial gap seen in outcomes among NHL survivors.
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