社会脆弱性指数对多发性骨髓瘤死亡率的影响。

IF 2.5 3区医学 Q3 ONCOLOGY

Oncology Pub Date : 2025-03-28 DOI:10.1159/000545459

Jia Yi Tan, Boon Jian San, Tze Ern Ong, Yong Hao Yeo, Modupe Idowu

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Age-adjusted mortality rates (AAMRs) per 100,000 individuals for patients aged 25 years and above were analyzed. Rate ratio (RD) was measured by calculating the ratio of the AAMRs in SVI-Q4 to SVI-Q1. Results Between 2016 and 2020, 61,307 MM-related deaths occurred, with 20,390 in SVI-Q4 versus 8,498 in SVI-Q1. Overall, AAMR was higher in SVI-Q4 (4.90; 95% CI, 4.83-4.97) than in SVI-Q1 (4.66; 95% CI, 4.56-4.76), though the RR was not significant (1.05; 95% CI, 0.81-1.36). Higher SVI was not significantly associated with higher AAMR among males (RR: 1.03; 95% CI, 0.73-1.45) or females (RR: 1.10; 95% CI, 0.75-1.62), Among the younger patients (25 - 64 years old) and the older patients (65 years old and above), increasing SVI was not associated with higher AAMR (RR: 1.27 [95% CI, 0.69 - 2.34] and 1.01 [95%, 0.76 - 1.34] respectively). SVI was also not significantly associated with higher AAMR in the rural populations (1.07 [95% CI, 0.60-1.92]). Across racial groups-American Indians, Asians, African Americans, Hispanics, and Whites-SVI was not significantly associated with AAMR differences. Similarly, no significant differences were observed when stratified by census regions (Northeast, Midwest, South, and West). Conclusion African Americans had higher AAMRs from MM compared to other racial groups. However, SVI scores were not significantly associated with MM mortality disparities. These findings suggest that SVI alone is insufficient to determine mortality disparities in MM. 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引用次数: 0

摘要

在过去的几十年里，美国多发性骨髓瘤（MM）的发病率一直在增加，并且存在持续的人口差异。健康的社会决定因素（SDOH）被发现影响某些疾病的健康结果。然而，关于SDOH对MM死亡率影响的数据有限。我们的研究旨在调查2016年至2020年SDOH与MM死亡率之间的关系。方法将来自美国疾病预防控制中心/有毒物质和疾病登记处社会脆弱性指数（CDC/ATSDR SVI）的县级数据与CDC WONDER数据库中的MM死亡率进行相关性分析。根据SVI得分将县分为四个四分位数：SVI- q1（最低脆弱性）至SVI- q4（最高脆弱性）。分析25岁及以上患者每10万人的年龄调整死亡率（AAMRs）。通过计算SVI-Q4中aamr与SVI-Q1中aamr的比值来测量Rate ratio （RD）。2016年至2020年间，发生了61,307例mm相关死亡，其中SVI-Q4为20,390例，SVI-Q1为8,498例。总体而言，SVI-Q4的AAMR更高(4.90；95% CI, 4.83-4.97)高于SVI-Q1 (4.66；95% CI, 4.56-4.76)，但RR不显著(1.05；95% ci, 0.81-1.36)。男性较高的SVI与较高的AAMR无显著相关(RR: 1.03；95% CI, 0.73-1.45)或女性(RR: 1.10；在年轻患者（25 ~ 64岁）和老年患者（65岁及以上）中，SVI升高与AAMR升高无关（RR分别为1.27 [95% CI, 0.69 ~ 2.34]和1.01[95%,0.76 ~ 1.34]）。在农村人群中，SVI也与较高的AAMR无显著相关（1.07 [95% CI, 0.60-1.92]）。跨种族群体——美洲印第安人、亚洲人、非洲裔美国人、西班牙裔美国人和白人——svi与AAMR差异无显著相关。同样，按人口普查地区（东北、中西部、南部和西部）分层时，也没有观察到显著差异。结论非裔美国人与其他种族相比，MM的aamr更高。然而，SVI评分与MM死亡率差异无显著相关。这些发现表明，单纯SVI不足以确定MM的死亡率差异。未来的研究应探索更具体的指标，以确定高危人群和解决MM的死亡率不平等问题。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Impact of Social Vulnerability Index on Multiple Myeloma Mortality.

Introduction The incidence of multiple myeloma (MM) in the United States has been increasing over the past decades with persistent demographic disparities. Social determinants of health (SDOH) were found to affect health outcomes among certain diseases. However, there was limited data on the impact of SDOH on the MM mortality rates. Our study aimed to investigate the association between the SDOH and MM mortality rates from 2016 to 2020. Methods County-level data from the Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry Social Vulnerability Index (CDC/ATSDR SVI) were correlated with MM mortality rates from the CDC WONDER database. Counties were categorized into four quartiles based on SVI scores: SVI-Q1 (lowest vulnerability) to SVI-Q4 (highest vulnerability). Age-adjusted mortality rates (AAMRs) per 100,000 individuals for patients aged 25 years and above were analyzed. Rate ratio (RD) was measured by calculating the ratio of the AAMRs in SVI-Q4 to SVI-Q1. Results Between 2016 and 2020, 61,307 MM-related deaths occurred, with 20,390 in SVI-Q4 versus 8,498 in SVI-Q1. Overall, AAMR was higher in SVI-Q4 (4.90; 95% CI, 4.83-4.97) than in SVI-Q1 (4.66; 95% CI, 4.56-4.76), though the RR was not significant (1.05; 95% CI, 0.81-1.36). Higher SVI was not significantly associated with higher AAMR among males (RR: 1.03; 95% CI, 0.73-1.45) or females (RR: 1.10; 95% CI, 0.75-1.62), Among the younger patients (25 - 64 years old) and the older patients (65 years old and above), increasing SVI was not associated with higher AAMR (RR: 1.27 [95% CI, 0.69 - 2.34] and 1.01 [95%, 0.76 - 1.34] respectively). SVI was also not significantly associated with higher AAMR in the rural populations (1.07 [95% CI, 0.60-1.92]). Across racial groups-American Indians, Asians, African Americans, Hispanics, and Whites-SVI was not significantly associated with AAMR differences. Similarly, no significant differences were observed when stratified by census regions (Northeast, Midwest, South, and West). Conclusion African Americans had higher AAMRs from MM compared to other racial groups. However, SVI scores were not significantly associated with MM mortality disparities. These findings suggest that SVI alone is insufficient to determine mortality disparities in MM. Future research should explore more specific indicators to identify at-risk populations and address mortality inequities in MM.

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来源期刊

Oncology 医学-肿瘤学

CiteScore

6.00

自引率

2.90%

发文量

审稿时长

6-12 weeks

期刊介绍： Although laboratory and clinical cancer research need to be closely linked, observations at the basic level often remain removed from medical applications. This journal works to accelerate the translation of experimental results into the clinic, and back again into the laboratory for further investigation. The fundamental purpose of this effort is to advance clinically-relevant knowledge of cancer, and improve the outcome of prevention, diagnosis and treatment of malignant disease. The journal publishes significant clinical studies from cancer programs around the world, along with important translational laboratory findings, mini-reviews (invited and submitted) and in-depth discussions of evolving and controversial topics in the oncology arena. A unique feature of the journal is a new section which focuses on rapid peer-review and subsequent publication of short reports of phase 1 and phase 2 clinical cancer trials, with a goal of insuring that high-quality clinical cancer research quickly enters the public domain, regardless of the trial’s ultimate conclusions regarding efficacy or toxicity.