Racial Disparities in Survival Among Non-Hodgkin Lymphoma (NHL) Patients: An Analysis of the SEER Database (2007-2015).

Abstract Introduction: Non-Hodgkin lymphoma (NHL) is the sixth leading cause of cancer deaths in the United States. Although disparities in cancer survival exist across different races/ethnicity, the underlying factors are not fully understood. Aim: To identify the interaction between race/ethnicity and insurance type and how this influences survival among NHL patients. Method: We utilized the SEER Registry to identify patients with a primary diagnosis of NHL from 2007–2015. Our primary outcome of interest was the Hazard of death following a diagnosis of NHL. In addition, we utilized the cox regression model to explore the interaction between race and insurance type and how this influences survival among NHL patients. Results: There were 44,609 patients with NHL who fulfilled the study criteria. The mean age at diagnosis was 50.9 ± 10.8 years, with a mean survival of 49.8 ± 34.5 months. Among these patients, 64.8% were Non-Hispanic Whites, 16% were Hispanics, and 10.8% Blacks. 76.5% of the study population had private insurance, 16.6% had public insurance, and 6.9% were uninsured. Blacks had the worst survival (HR = 1.66; 95% = 1.55–1.78). Patients on private insurance had better survival compared to those with public insurance (HR = 2.11; 95% CI = 2.00-2.24) Conclusion: Black patients have a worse outcome than Whites even after controlling for treatment modalities, age, disease stage, and insurance status.