Income, education and their impact on treatments and survival in patients with myelodysplastic syndromes
Objectives To assess whether socioeconomic indices such as income and educational level can explain part of the variation in survival among patients with myelodysplastic syndromes, and further to assess whether these factors influence care and treatment decisions. Methods Population‐based cohort stu...
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| Veröffentlicht in: | European journal of haematology 2021-08, Vol.107 (2), p.219-228 |
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| container_title | European journal of haematology |
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| creator | Larfors, Gunnar Moreno Berggren, Daniel Garelius, Hege Jädersten, Martin Nilsson, Lars Rasmussen, Bengt Ejerblad, Elisabeth |
| description | Objectives
To assess whether socioeconomic indices such as income and educational level can explain part of the variation in survival among patients with myelodysplastic syndromes, and further to assess whether these factors influence care and treatment decisions.
Methods
Population‐based cohort study on 2945 Swedish patients diagnosed between 2009 and 2018 and included in the Swedish MDS Register. Relative mortality was assessed by Cox regression, whereas treatment differences were assessed by Poisson regression. Regarding mortality, patients were also compared to a matched comparison group from the general population.
Results
Mortality was 50% higher among patients in the lowest income category compared to the highest and 40% higher in patients with mandatory school education only compared to those with college or university education. Treatment with hypomethylating agents and allogeneic stem cell transplantation, as well as investigation with cytogenetic diagnostics were also linked to income and education. The findings were not explained by differences in risk class or comorbidity at the time of diagnosis.
Conclusions
Income and education are linked to survival among patients with myelodysplastic syndromes. Socioeconomic status also seems to influence treatment intensity as patients with less income and education to a lesser degree receive hypomethylating agents and transplants. |
| doi_str_mv | 10.1111/ejh.13641 |
| format | Article |
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To assess whether socioeconomic indices such as income and educational level can explain part of the variation in survival among patients with myelodysplastic syndromes, and further to assess whether these factors influence care and treatment decisions.
Methods
Population‐based cohort study on 2945 Swedish patients diagnosed between 2009 and 2018 and included in the Swedish MDS Register. Relative mortality was assessed by Cox regression, whereas treatment differences were assessed by Poisson regression. Regarding mortality, patients were also compared to a matched comparison group from the general population.
Results
Mortality was 50% higher among patients in the lowest income category compared to the highest and 40% higher in patients with mandatory school education only compared to those with college or university education. Treatment with hypomethylating agents and allogeneic stem cell transplantation, as well as investigation with cytogenetic diagnostics were also linked to income and education. The findings were not explained by differences in risk class or comorbidity at the time of diagnosis.
Conclusions
Income and education are linked to survival among patients with myelodysplastic syndromes. Socioeconomic status also seems to influence treatment intensity as patients with less income and education to a lesser degree receive hypomethylating agents and transplants.</description><identifier>ISSN: 0902-4441</identifier><identifier>ISSN: 1600-0609</identifier><identifier>EISSN: 1600-0609</identifier><identifier>DOI: 10.1111/ejh.13641</identifier><identifier>PMID: 34028869</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cohort analysis ; cohort studies ; Cytogenetics ; Disease Management ; Education ; epidemiology ; Female ; Health Impact Assessment ; Health Knowledge, Attitudes, Practice ; Humans ; Income ; Male ; Middle Aged ; Mortality ; Myelodysplastic syndrome ; myelodysplastic syndromes ; Myelodysplastic Syndromes - diagnosis ; Myelodysplastic Syndromes - epidemiology ; Myelodysplastic Syndromes - mortality ; Myelodysplastic Syndromes - therapy ; Population studies ; Prognosis ; Public Health Surveillance ; Socioeconomic Factors ; Stem cell transplantation ; Sweden - epidemiology ; Transplants & implants ; Young Adult</subject><ispartof>European journal of haematology, 2021-08, Vol.107 (2), p.219-228</ispartof><rights>2021 The Authors. published by John Wiley & Sons Ltd.</rights><rights>2021 The Authors. European Journal of Haematology published by John Wiley & Sons Ltd.</rights><rights>2021. This article is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5001-52d7eb62d7de605aebbd6cd577a4bbba74fb843313a4319f3eebc21a419978a43</citedby><cites>FETCH-LOGICAL-c5001-52d7eb62d7de605aebbd6cd577a4bbba74fb843313a4319f3eebc21a419978a43</cites><orcidid>0000-0002-1549-8695</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fejh.13641$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fejh.13641$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>230,314,550,776,780,881,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34028869$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-92070$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-454199$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:146681049$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Larfors, Gunnar</creatorcontrib><creatorcontrib>Moreno Berggren, Daniel</creatorcontrib><creatorcontrib>Garelius, Hege</creatorcontrib><creatorcontrib>Jädersten, Martin</creatorcontrib><creatorcontrib>Nilsson, Lars</creatorcontrib><creatorcontrib>Rasmussen, Bengt</creatorcontrib><creatorcontrib>Ejerblad, Elisabeth</creatorcontrib><title>Income, education and their impact on treatments and survival in patients with myelodysplastic syndromes</title><title>European journal of haematology</title><addtitle>Eur J Haematol</addtitle><description>Objectives
To assess whether socioeconomic indices such as income and educational level can explain part of the variation in survival among patients with myelodysplastic syndromes, and further to assess whether these factors influence care and treatment decisions.
Methods
Population‐based cohort study on 2945 Swedish patients diagnosed between 2009 and 2018 and included in the Swedish MDS Register. Relative mortality was assessed by Cox regression, whereas treatment differences were assessed by Poisson regression. Regarding mortality, patients were also compared to a matched comparison group from the general population.
Results
Mortality was 50% higher among patients in the lowest income category compared to the highest and 40% higher in patients with mandatory school education only compared to those with college or university education. Treatment with hypomethylating agents and allogeneic stem cell transplantation, as well as investigation with cytogenetic diagnostics were also linked to income and education. The findings were not explained by differences in risk class or comorbidity at the time of diagnosis.
Conclusions
Income and education are linked to survival among patients with myelodysplastic syndromes. Socioeconomic status also seems to influence treatment intensity as patients with less income and education to a lesser degree receive hypomethylating agents and transplants.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cohort analysis</subject><subject>cohort studies</subject><subject>Cytogenetics</subject><subject>Disease Management</subject><subject>Education</subject><subject>epidemiology</subject><subject>Female</subject><subject>Health Impact Assessment</subject><subject>Health Knowledge, Attitudes, Practice</subject><subject>Humans</subject><subject>Income</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Myelodysplastic syndrome</subject><subject>myelodysplastic syndromes</subject><subject>Myelodysplastic Syndromes - diagnosis</subject><subject>Myelodysplastic Syndromes - epidemiology</subject><subject>Myelodysplastic Syndromes - mortality</subject><subject>Myelodysplastic Syndromes - therapy</subject><subject>Population studies</subject><subject>Prognosis</subject><subject>Public Health Surveillance</subject><subject>Socioeconomic Factors</subject><subject>Stem cell transplantation</subject><subject>Sweden - epidemiology</subject><subject>Transplants & implants</subject><subject>Young Adult</subject><issn>0902-4441</issn><issn>1600-0609</issn><issn>1600-0609</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>EIF</sourceid><sourceid>D8T</sourceid><recordid>eNqNkktv1DAUhS0EokNhwR9AkdgUqWmvY-e1rEqhRZXYAFvLjzuMhyQOdtxR_j2eydAFUiW8sK1zP59r2YeQtxQuaBqXuN1cUFZx-oysaAWQQwXtc7KCFoqcc05PyKsQtgBQtLR-SU4Yh6JpqnZFNneDdj2eZ2iilpN1QyYHk00btD6z_Sj1lCVt8iinHocpHMoh-gf7ILvMDtmYTh0KOzttsn7Gzpk5jJ0Mk9VZmAfjU4PwmrxYyy7gm-N6Sr5_uvl2fZvff_18d311n-sSgOZlYWpUVZoNVlBKVMpU2pR1LblSStZ8rRrOGGWSM9quGaLSBZWctm3dJO2U5Itv2OEYlRi97aWfhZNWHKVfaYeCV7SBKvHnT_If7Y8r4fxPEaPg5b7F_-HOR9EWUEPCzxZ89O53xDCJ3gaNXScHdDGIomS0ZKwpmoS-_wfduuiH9FaJ4k0LlPK94YeF0t6F4HH9eAMKYh8GkcIgDmFI7LujY1Q9mkfy7-8n4HIBdrbD-WkncfPldrH8A8PQwCM</recordid><startdate>202108</startdate><enddate>202108</enddate><creator>Larfors, Gunnar</creator><creator>Moreno Berggren, Daniel</creator><creator>Garelius, Hege</creator><creator>Jädersten, Martin</creator><creator>Nilsson, Lars</creator><creator>Rasmussen, Bengt</creator><creator>Ejerblad, Elisabeth</creator><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QG</scope><scope>7T5</scope><scope>7TM</scope><scope>7TO</scope><scope>H94</scope><scope>7X8</scope><scope>AABEP</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D8T</scope><scope>D91</scope><scope>ZZAVC</scope><scope>ACNBI</scope><scope>DF2</scope><orcidid>https://orcid.org/0000-0002-1549-8695</orcidid></search><sort><creationdate>202108</creationdate><title>Income, education and their impact on treatments and survival in patients with myelodysplastic syndromes</title><author>Larfors, Gunnar ; Moreno Berggren, Daniel ; Garelius, Hege ; Jädersten, Martin ; Nilsson, Lars ; Rasmussen, Bengt ; Ejerblad, Elisabeth</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5001-52d7eb62d7de605aebbd6cd577a4bbba74fb843313a4319f3eebc21a419978a43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cohort analysis</topic><topic>cohort studies</topic><topic>Cytogenetics</topic><topic>Disease Management</topic><topic>Education</topic><topic>epidemiology</topic><topic>Female</topic><topic>Health Impact Assessment</topic><topic>Health Knowledge, Attitudes, Practice</topic><topic>Humans</topic><topic>Income</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Myelodysplastic syndrome</topic><topic>myelodysplastic syndromes</topic><topic>Myelodysplastic Syndromes - diagnosis</topic><topic>Myelodysplastic Syndromes - epidemiology</topic><topic>Myelodysplastic Syndromes - mortality</topic><topic>Myelodysplastic Syndromes - therapy</topic><topic>Population studies</topic><topic>Prognosis</topic><topic>Public Health Surveillance</topic><topic>Socioeconomic Factors</topic><topic>Stem cell transplantation</topic><topic>Sweden - epidemiology</topic><topic>Transplants & implants</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Larfors, Gunnar</creatorcontrib><creatorcontrib>Moreno Berggren, Daniel</creatorcontrib><creatorcontrib>Garelius, Hege</creatorcontrib><creatorcontrib>Jädersten, Martin</creatorcontrib><creatorcontrib>Nilsson, Lars</creatorcontrib><creatorcontrib>Rasmussen, Bengt</creatorcontrib><creatorcontrib>Ejerblad, Elisabeth</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Animal Behavior Abstracts</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><collection>SWEPUB Örebro universitet full text</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Freely available online</collection><collection>SWEPUB Örebro universitet</collection><collection>SwePub Articles full text</collection><collection>SWEPUB Uppsala universitet full text</collection><collection>SWEPUB Uppsala universitet</collection><jtitle>European journal of haematology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Larfors, Gunnar</au><au>Moreno Berggren, Daniel</au><au>Garelius, Hege</au><au>Jädersten, Martin</au><au>Nilsson, Lars</au><au>Rasmussen, Bengt</au><au>Ejerblad, Elisabeth</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Income, education and their impact on treatments and survival in patients with myelodysplastic syndromes</atitle><jtitle>European journal of haematology</jtitle><addtitle>Eur J Haematol</addtitle><date>2021-08</date><risdate>2021</risdate><volume>107</volume><issue>2</issue><spage>219</spage><epage>228</epage><pages>219-228</pages><issn>0902-4441</issn><issn>1600-0609</issn><eissn>1600-0609</eissn><abstract>Objectives
To assess whether socioeconomic indices such as income and educational level can explain part of the variation in survival among patients with myelodysplastic syndromes, and further to assess whether these factors influence care and treatment decisions.
Methods
Population‐based cohort study on 2945 Swedish patients diagnosed between 2009 and 2018 and included in the Swedish MDS Register. Relative mortality was assessed by Cox regression, whereas treatment differences were assessed by Poisson regression. Regarding mortality, patients were also compared to a matched comparison group from the general population.
Results
Mortality was 50% higher among patients in the lowest income category compared to the highest and 40% higher in patients with mandatory school education only compared to those with college or university education. Treatment with hypomethylating agents and allogeneic stem cell transplantation, as well as investigation with cytogenetic diagnostics were also linked to income and education. The findings were not explained by differences in risk class or comorbidity at the time of diagnosis.
Conclusions
Income and education are linked to survival among patients with myelodysplastic syndromes. Socioeconomic status also seems to influence treatment intensity as patients with less income and education to a lesser degree receive hypomethylating agents and transplants.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>34028869</pmid><doi>10.1111/ejh.13641</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-1549-8695</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | European journal of haematology, 2021-08, Vol.107 (2), p.219-228 |
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| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; SWEPUB Freely available online |
| subjects | Adolescent Adult Aged Aged, 80 and over Cohort analysis cohort studies Cytogenetics Disease Management Education epidemiology Female Health Impact Assessment Health Knowledge, Attitudes, Practice Humans Income Male Middle Aged Mortality Myelodysplastic syndrome myelodysplastic syndromes Myelodysplastic Syndromes - diagnosis Myelodysplastic Syndromes - epidemiology Myelodysplastic Syndromes - mortality Myelodysplastic Syndromes - therapy Population studies Prognosis Public Health Surveillance Socioeconomic Factors Stem cell transplantation Sweden - epidemiology Transplants & implants Young Adult |
| title | Income, education and their impact on treatments and survival in patients with myelodysplastic syndromes |
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