Racial and Socioeconomic Disparities in Cutaneous T-Cell Lymphoma Survival: Insights From the National Cancer Database.

OBJECTIVE

To analyze the impacts of treatment related factors, race, and social determinants of health (SDOH) on patients with cutaneous T-cell lymphoma (CTCL) using a hospital-based registry system.

METHODS

Patients with CTCL diagnosed from 2004 to 2019 were identified from the National Cancer Database (NCDB). Kaplan-Meier analysis, Cox proportional hazards regression models, and Propensity Score Matching (PSM) were conducted to compare the overall survival between white and Black patients.

RESULTS

The NCDB cohort (n = 16,189) included 12,266 (75.8%) white patients, 2849 (17.6%) Black patients, and 1074 (6.6%) other races. There were differences in disease, treatment characteristics and SDOH by racial group. Black patients traveled shorter distances (20.3% vs. 28.9%, P < .001) for treatment and were more likely to reside in urban centers. Rurality (HR 1.74 (1.41-2.15)) and treatment at non-academic/research programs (HR 1.21 (95% CI, 1.11-1.31) were associated with increased risks of death. PSM controlling for demographic, disease, SDOH, and treatment-related variables, demonstrated increased risk of death among Black patients (HR:1.20 (95% CI, 1.10-1.30) P < .001).

LIMITATIONS: Lack of detailed treatment data and misclassified cases may limit the validity of the study.

CONCLUSION

Black patients have a 20% increased risk of death despite controlling for patient, disease, treatment, and social factors.