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Socioeconomic Status Impacts Cancer Mortality Rates

Swedish study of hematologic cancers finds higher status correlates to lower mortality

MONDAY, March 23 (HealthDay News) -- Despite Sweden's nationwide health care, people with higher socioeconomic status have lower mortality rates for two common hematologic cancers than those with lower socioeconomic status, according to a report in the March 16 issue of the Journal of Clinical Oncology.

Sigurdur Yngvi Kristinsson, M.D., of Karolinska University Hospital Solna in Stockholm, Sweden, and colleagues evaluated data from the Swedish Cancer Registry on 9,165 patients with acute myeloid leukemia and 14,744 patients with multiple myeloma. The data was stratified to four time periods: 1973 to 1979, 1980 to 1989, 1990 to 1999, and 2000 to 2005. The patients were sorted into groups by socioeconomic status, including: higher white collar, lower white collar, blue collar, self-employed, farmer, retired and unknown. Relative risk of death was assessed using the Cox proportional hazards regression.

Higher white-collar workers had the lowest mortality for acute myeloid leukemia and multiple myeloma of all the groups, the investigators found. Blue-collar workers had the highest acute myeloid leukemia mortality rate (hazard ratio 1.22), followed by the self-employed (hazard ratio 1.20). Lower white-collar workers had the highest multiple myeloma mortality rate (hazard ratio 1.22) followed by blue-collar workers (hazard ratio 1.15), the researchers report. The socioeconomic differences were most marked for multiple myeloma in the time periods 1990 to 1999 and 2000 to 2005, the report indicates.

"It is possible that patients in higher socioeconomic status groups get earlier access to these newer agents and procedures, with an established impact on survival, in part explaining the growing survival differences observed after the year 1990," the authors write.

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