LUCIANO JOSE COSTA , M . D ., PH . D .
A new UAB study has revealed that socioeconomic factors , not race or ethnicity , influence the survival of younger multiple myeloma patients .
Advances in treatment of multiple myeloma have led to improved survival , predominantly among young and white patients , with fewer benefits experienced by patients of other ethnicities .
The UAB study , which was published in Cancer , a peer-reviewed journal of the American Cancer Society , indicates this gap is due mostly to socioeconomic differences such as marital status , income and insurance status that directly and independently affect the chances of survival among younger multiple myeloma patients , not necessarily race or ethnic background .
Luciano Jose Costa , M . D ., Ph . D ., associate professor in the UAB Division of Hematology and Oncology and UAB Comprehensive Cancer Center scientist , led a team that studied data of more than 10,000 multiple myeloma patients in the United States who were under the age of 65 – the largest and most complete study to address the impact of sociodemographic factors on survival of myeloma patients in that age group .
“ When socioeconomic factors were accounted for , we found that race did not impact survival ,” Dr . Costa says .
Multiple myeloma , a cancer that forms in a type of white blood cell , is the second-most common hematologic malignancy in the United States , with 30,300 new cases expected in 2016 . Multiple myeloma is a rare cancer , and the mortality rate is high with a five-year survival rate of only 47 percent . It most frequently occurs in patients 65 or older ; however , about 38 percent of new cases are age 65 or younger .
Although it has been known that African- American patients have had reduced improvement in outcomes compared to Caucasian patients , Dr . Costa and his team suspected it was more complex than that . They found that the four-year estimated survival was 71.1 percent , 63.2 percent , 53.4 percent and 46.5 percent for patients with zero , one , two or three adverse sociodemographic factors , respectively . For instance , a patient who is not married , lives in a lowincome county and is a beneficiary of Medicare has a 25 percent lower chance of being alive in four years after diagnosis than a patient of the same age who is married and lives in a medium- to high-income county and has private insurance .
“ Our findings strongly suggest there is a huge disparity in outcomes that could potentially be overcome by improving access and affordability of treatment ,” says Dr . Costa . “ With the recent emphasis on comparative effectiveness in oncology , it also becomes crucial that all variables affecting outcomes , including sociodemographic factors , are accounted for when comparisons between different therapeutic approaches and health care systems are made .”
The bottom line , according to Dr . Costa , is that “ these potentially avoidable determinants indicate new opportunities for improving outcomes for multiple myeloma patients .”
“ Our findings strongly suggest there is a huge disparity in outcomes that could potentially be overcome by improving access and affordability of treatment .”
Luciano Jose Costa , M . D ., Ph . D ., associate professor in the UAB Division of Hematology and Oncology and UAB Comprehensive Cancer Center scientist
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