Maheswaran, R. orcid.org/0000-0002-3899-4421 and Morley, N. orcid.org/0000-0002-0497-975X (2018) Incidence, socioeconomic deprivation, volume-outcome and survival in adult patients with acute lymphoblastic leukaemia in England. BMC Cancer, 18 (1). 25. ISSN 1471-2407
Abstract
BACKGROUND:
We examined incidence and survival in relation to age, gender, socioeconomic deprivation, rurality and trends over time. We also examined the association between volume of patients treated by hospitals and survival.
METHODS:
Incident cases (2001-12) were identified using comprehensive National Health Service admissions data for England, with follow-up to March 2013. Socioeconomic deprivation was based on census area of residence. Volume was assessed in a three-year subset of the data with consistent hospital provider codes.
RESULTS:
There were 2921 adults aged 18 or more years diagnosed with acute lymphoblastic leukaemia (ALL) in the 12-year time span, giving a crude annual incidence of 0.61/100,000 population. Five-year survival was 32% (1870 deaths). Compared with patients living in least deprived areas, survival was worse for patients living in intermediate and most deprived areas, with mortality hazard ratios 21% (95% CI 8-35%) and 16% (95% CI 3-30%) higher respectively. Hospitals treating low volumes of adults with ALL were associated with poorer survival. The adjusted mortality hazard ratio in this subset of 465 patients was 33% (95% CI 3-73%) higher in low volume hospitals. There was no evidence of association between socioeconomic deprivation and incidence. Rurality did not appear to be associated with incidence or survival. Incidence was higher in men but there was no evidence of a gender difference in survival. Survival improved over time.
CONCLUSION:
The associations between socioeconomic deprivation and survival and between volume and outcome for adults with ALL, if confirmed, are likely to have significant implications for the organisation of services for adults with ALL.
Metadata
Item Type: | Article |
---|---|
Authors/Creators: |
|
Copyright, Publisher and Additional Information: | © 2018 The Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
Keywords: | Acute lymphoblastic leukaemia; Incidence; Survival; Mortality; Socioeconomic deprivation |
Dates: |
|
Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > The Medical School (Sheffield) The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) > ScHARR - Sheffield Centre for Health and Related Research The University of Sheffield > Sheffield Teaching Hospitals |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 09 Jan 2018 14:55 |
Last Modified: | 15 Mar 2024 15:51 |
Status: | Published |
Publisher: | BioMed Central |
Refereed: | Yes |
Identification Number: | 10.1186/s12885-017-3975-0 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:125956 |