Table 3.
Summary of descriptive characteristics of included studies evaluating median household income (n = 27), percentage of population living in poverty (n = 4), and unemployment rate (n = 2)
| Author (year) | Data source years |
US region | Patients N |
Outcome/analysis | Cohorts | HR (95% CI) | Social determinant associated with worse survival |
|---|---|---|---|---|---|---|---|
| Median household income (annual) | |||||||
| Parikh et al,39 (2015) | NCDB 1998-2011 |
National | HL 45 777 |
OS/multi | < $30 000 $30 000-34 999 $35 000-45 999 ≥46 000 |
Ref. 0.86 (0.74-0.99)∗ 0.84 (0.72-0.97)∗ 0.81 (0.69-0.95)∗ |
Income lower than $30 000 |
| Loberiza et al,30 (2009) | UNMC 1982-2006 |
NE | HL 2 330 |
OS/multi | ≤ $30 000 $30 001-39 999 $ 40 000-44 999 ≥ $45 000 |
Data not showed | - |
| Keegan (2009) | CCR 1988-2006 |
CA | HL 15-44 y.o. 8228 |
CCS/multi | 5: Highest‡ 1: Lowest 2 3 4 |
Ref. 1.64 (1.23-2.20)∗ 1.48 (1.13-1.94)∗ 1.63 (1.26-2.10)∗ 1.23 (0.95-1.61) |
Lower income |
| OS/multi | 5: Highest‡ 1: Lowest 2 3 4 |
Ref. 1.81 (1.46-2.24)∗ 1.57 (1.29-1.92)∗ 1.58 (1.30-1.91)∗ 1.28 (1.06-1.56)∗ |
Lower income | ||||
| HL ≥ 45 y.o. 4264 |
CCS/multi | 5: Highest‡ 1: Lowest 2 3 4 |
Ref. 1.36 (1.10-1.68) 1.27 (1.04-1.54) 1.19 (0.98-1.44) 1.00 (0.82-1.21) |
Lower income | |||
| OS/multi | 5: Highest‡ 1: Lowest 2 3 4 |
Ref. 1.44 (1.26-1.66) 1.26 (1.01-1.44) 1.31 (1.15-1.48) 1.06 (0.93-1.20) |
Lower income | ||||
| Dhakal et al,22 (2019) | NCDB 2006-2012 |
National | NHL 132 402 |
1-month mortality/uni | < $38 000 $38 000-47 999 $48 000-62 999 ≥ $63 000 |
Data not showed | Lower income |
| 1-month mortality/multi | < $38 000 $38 000-47 999 $48 000-62 999 ≥ $63 000 |
Data not showed | - | ||||
| OS/multi | < $38 000 $38 000-47 999 $48 000-62 999 ≥ $63 000 |
Ref. 0.95 (0.92-0.98) 0.91 (0.88-0.95)∗ 0.86 (0.82-0.90)∗ |
Income lower than $38 000 | ||||
| Go (2016) | NCDB 1998-2011 |
National |
NHL 278 985 |
OS/multi | ≥ $46 000 $35 000-$45 999 $30 000-$34 999 < $30 000 |
Ref. 1.10 (1.09-1.11)† 1.16 (1.15-1.18)† 1.25 (1.23-1.27)† |
Income lower than $45 999 |
| Tao et al,25 (2014) | CCR 2001-2009 |
CA | NHL 16 133 |
CSS/multi | 5. Highest 20%‡ 1. Lowest 20% 2. 3. 4. |
Ref. 1.24 (1.16-1.32)∗ 1.23 (1.16-1.30)∗ 1.12 (1.06-1.18)∗ 1.07 (1.02-1.13)∗ |
Lower income |
| OS/multi | 5. Highest 20%‡ 1. Lowest 20% 2. 3. 4. |
Ref. 1.34 (1.27-1.40)∗ 1.26 (1.20-1.32)∗ 1.17 (1.12-1.22)∗ 1.09 (1.05-1.14)∗ |
Lower income | ||||
| Ai et al,26 (2012) | CCR 2001-2008 |
CA | NHL 213 |
OS/multi | High: Quartile 4, 5 Low: Quartile 1-3 |
Ref. 1.07 (0.73-1.57) |
- |
| Shah (2019) | NCDB 2004-2013 |
National | NHL 18 120 |
OS/multi | ≥ $63 000 < $38 000 $38 000-47 999 $48 000-62 999 |
Ref. 1.21 (1.10-1.33)∗ 1.06 (0.98-1.15) 1.01 (0.94-1.08) |
Income lower than $38 000 |
| Chohan et al,18 (2022) | NCDB 2004-2017 |
National | WM < 65 y.o. 1249 |
OS/uni | < $40 227 $40 227–50 353 $50 354–63 332 ≥$63 333 |
Ref. 0.77 (0.48-1.24) 0.60 (0.38-0.96)∗ 0.55 (0.36-0.83)∗ |
Income lower than $40 227 |
| OS/multi | < $40 227 $40 227–50 353 $50 354–63 332 ≥ $63 333 |
Ref. 1.16 (0.65-2.07) 0.97 (0.51-1.82) 1.12 (0.56-2.23) |
- | ||||
| WM ≥ 65 y.o. 2629 |
OS/uni | < $40 227 $40 227–50 353 $50 354–63 332 ≥ $63 333 |
Ref. 0.98 (0.77-1.25) 0.84 (0.67-1.07) 0.76 (0.61-0.95)∗ |
Income lower than $40 227 | |||
| OS/multi | < $40 227 $40 227–50 353 $50 354–63 332 ≥ $63 333 |
Ref. 1.02 (0.78-1.35) 0.93 (0.70-1.24) 0.90 (0.66-1.22) |
- | ||||
| Gunaratne et al,35 (2021) | NCBD 2004-2014 |
National | WM 3 064 |
OS/multi | ≥ $63 000 $48 000–$62 999 $38 000–$47 999 <$38 000 |
Ref. 1.19 (0.98-1.44) 1.21 (0.98-1.51) 1.25 (0.96-1.63) |
- |
| Fiala et al,15 (2015) | Institutional 2000-2009 |
MO | MM 652 |
OS/HR | ≥ $57 177 $41 401-57 177 ≤ $41 400 |
Ref. 1.25 (0.95-1.65) 1.54 (1.13-2.09)∗ |
Income lower than $41 400 |
| SEER 2000-2009 |
National | MM 45 505 |
OS/HR | ≥ $57 177 $41 401-57 177 ≤ $41 400 |
Ref. 1.10 (1.07-1.13)∗ 1.18 (1.15-1.22)∗ |
Income lower than $57 177 | |
| Jayakrishnan (2021) | NCDB 2004-2016 |
National | MM 50 543 |
OS/multi | < $38 000 $38 000-47 999 $48 000-62 999 ≥ $63 000 |
Ref. 0.96 (0.93-0.99)∗ 0.93 (0.90-0.97)∗ 0.91 (0.87-0.95)∗ |
Income lower than $38 000 |
| Evans et al,40 (2021) | Institutional 2005-2015 | NS | MM 2543 |
OS/uni | ≥$63 000 < $63 000 |
Ref. 1.25 (1.09-1.43)∗ |
Income lower than $63 000 |
| OS/multi | ≥$63 000 < $63 000 |
Ref. 1.13 (0.89-1.43) |
- | ||||
| NCDB 2004-2015 |
National | MM 122 858 |
OS/multi | ≥$63 000 < $63 000 |
Ref. 1.11 (1.09-1.14)∗ |
Income lower than $63 000 | |
| Chamoun (2021) | NCDB. 2005-2014 |
National | MM. 117 926 |
OS/multi | ≥ $46 000 < $46 000 |
Ref. 1.16 (1.08-1.25)∗ |
Income lower than $46 000 |
| Ho et al,24 (2017) | CCR 1999-2012 |
CA | MM 6359 |
60-day mortality | High SES‡ Low SES |
Ref. 1.21 (1.03-1.41) |
Lower income |
| Costa et al,37 (2016) | SEER 2007-2012 |
National | MM 10 161 |
OS/multi | > $68 500 $56 601-$68 500 $49 301-$56 600 < $49 301 |
Ref. 0.97 (0.85-1.10) 1.19 (1.03-1.37)∗ 1.27 (1.09-1.49)∗ |
Income lower than $49 301 |
| Huang et al,31 (2021) | SEER 2007-2016 |
National | MM 17 981 |
CSS/uni | $1926-5000 $5007-6081 $6090-6504 $6517-8185 $8197-11 097 |
Ref. 0.98 (0.90-1.07) 0.92 (0.84-1.01) 0.85 (0.78-0.94)∗ 0.84 (0.76-0.92)∗ |
Income lower than $5000 |
| CSS/multi | $1926-5000 $5007-6081 $6090-6504 $6517-8185 $8197-11 097 |
Ref. 1.10 (0.91-1.30) 1.04 (0.85-1.26) 0.96 (0.76-1.22) 0.97 (0.75-1.25) |
- | ||||
| OS/uni | $1926-5000 $5007-6081 $6090-6504 $6517-8185 $8197-11 097 |
Ref. 0.95 (0.88-1.02) 0.86 (0.79-0.92)∗ 0.75 (0.70-0.81)∗ 0.69 (0.63-0.75)∗ |
Income lower than $5000 | ||||
| OS/multi | $1926-5000 $5007-6081 $6090-6504 $6517-8185 $8197-11 097 |
Ref. 1.07 (0.92-1.24) 0.91 (0.77-1.08) 0.93 (0.77-1.11) 1.00 (0.79-1.28) |
- | ||||
| Ghiassi-Nejad et al,23 (2019) | NCDB 2004-2013 |
National | PM P-bone 4056 |
OS/multi | < $38 000 $38 000-47 999 $48 000-62 999 ≥ $63 000 |
Ref. 0.78 (0.67-0.92)∗ 0.77 (0.65-0.89)∗ 0.72 (0.61-0.85)∗ |
Income lower than $38 000 |
| PM P-EM 1468 |
OS/uni | < $38 000 $38 000-47 999 $48 000-62 999 ≥ $63 000 |
Ref. 0.85 (0.65-1.11) 0.77 (0.59-1.01) 0.76 (0.58-0.98)∗ |
Income lower than $38 000 | |||
| OS/multi | < $38 000 $38 000-47 999 $48 000-62 999 ≥ $63 000 |
Ref. 0.94 (0.71-1.25) 0.84 (0.63-1.12) 0.84 (0.63-1.13) |
- | ||||
| Bhatt (2017) | NCDB 2003-2011 |
National | AML 60 738 |
1-month mortality/multi | ≥ 46 000 <$30 000 $30 000-34 999 $35 000-45 999 |
Ref. 1.26 (1.18-1.35)∗ 1.16 (1.10-1.24)∗ 1.12 (1.06-1.17)∗ |
Income lower than $45 999 |
| OS/multi | ≥ 46 000 < $30 000 $30 000-34 999 $35 000-45 999 |
Ref. 1.09 (1.05-1.12)∗ 1.07 (1.05-1.10)∗ 1.05 (1.03-1.07)∗ |
Income lower than $45 999 | ||||
| Freeman et al,32 (2016) | NC CCR 2003-2009 |
NC | AML 900 |
OS/multi | Fourth Quartile‡ First Quartile Second Quartile Third Quartile |
Ref. 1.22 (0.81-1.86) 1.18 (0.86-1.62) 1.02 (0.77-1.33) |
- |
| Borate et al,38 (2015) | SEER 2007-2011 |
National | AML 5541 |
2-month mortality/uni | Quintile 5‡ Quintile 1 Quintile 2 Quintile 3 Quintile 4 |
Ref. OR 1.60 (1.20-2.13)∗ 1.54 (1.16-2.04)∗ 1.43 (1.06-1.93)∗ 1.39 (1.04-1.86)∗ |
Lower income |
| OS/multi | Quintile 5‡ Quintile 1 Quintile 2 Quintile 3 Quintile 4 |
Ref. OR 1.21 (1.08-1.36)∗ 1.25 (1.11-1.40)∗ 1.25 (1.11-1.40)∗ 1.11 (0.99-1.25) |
Lower income | ||||
| Baker (2009) | CIBMTR 1995-2004 |
National | AML/ALL/CML/ MDS. 6207 | DFS | > $56 300 $43 600-56 300 $34 700-43 600 < $34 700 |
Ref. 1.03 (0.94-1.13) 1.02 (0.93-1.12) 1.12 (1.01-1.23) |
- |
| TRM | > $56 300 $43 600-56 300 $34 700-43 600 < $34 700 |
Ref. 1.11 (0.99-1.24) 1.11 (0.99-1.24) 1.21 (1.07-1.36)∗ |
Income lower than $34 700 | ||||
| OS | > $56 300 $43 600-56 300 $34 700-43 600 < $34 700 |
Ref. 1.06 (0.97-1.16) 1.06 (0.97-1.16) 1.15 (1.04-1.26)∗ |
Income lower than $34 700 | ||||
| Rodriguez et al,33 (2008) | Institutional 1997-2005 |
OH | AML 281 |
OS/multi | Per $10 000 increment | 1.02 (0.92-1.13) | - |
| Master et al,28 (2016) | NCDB 1998 -2012 |
National | AML 67 443 |
OS/multi | ≥ $46 000 $30 000 $30 000-34 000 $35 000-45 000 |
Ref. 1.10 (1.06-1.15)† 1.08 (1.05-1.12)† 1.05 (1.02-1.08)† |
Income lower than $46 000 |
| Bradley et al,34 (2011) | VCR/ VHI 1999-2006 |
VA | AML No CTX NS |
OS/multi | Advantage Disadvantage | Ref. 1.00 (0.99-1.01) |
- |
| AML CTX NS |
OS/multi | Advantage Disadvantage | Ref. 1.00 (0.99-1.01) |
- | |||
| Dhakal et al,17 (2022) | NCDB 2004-2015 |
National | APL <65 y.o. 5380 |
1-month mortality | ≥ $63 333 $50 354-63 332 $40 227-50 353 |
Ref. 1.02 (0.75-1.37) 1.08 (0.77-1.50) |
- |
| APL ≥65 y.o. 1520 |
1-month mortality | ≥ $63 333 $50 354-63 332 $40 227-50 353 |
Ref. 1.06 (0.72-1.54) 1.31 (0.87-1.98) |
- | |||
| APL <65 y.o. 5380 |
OS/multi | ≥ $63 333 $50 354-63 332 $40 227-50 353 |
Ref. 1.19 (1.00-1.42)∗ 1.03 (0.85-1.26) |
Income from $50 354 to $63 332 | |||
| APL ≥65 y.o. 1520 |
OS/multi | ≥ $63 333 $50 354-63 332 $40 227-50 353 < $40 227 |
Ref. 1.22 (1.00-1.49) 1.29 (1.03-1.60)∗ 1.36 (1.05-1.76)∗ |
Income lower than $63 333 | |||
| Perry et al,16 (2017) | SEER 2007-2012 |
National | CML < 64 y.o. 3626 |
OS/HR | Above median household income | 0.98 (0.69-1.40) | - |
| CML ≥ 65 y.o. 2142 |
OS/HR | Above median household income | 1.02 (0.83-1.27) | - | |||
| Percentage of population living in poverty | |||||||
| Huang et al,31 (2021) | SEER 2007-2016 |
National | MM 17 981 |
CSS/uni | < 10% 10%–19.99% ≥ 20% |
Ref. 1.10 (1.02-1.19)∗ 1.20 (1.09-1.33)∗ |
Poverty level higher than 10% |
| CSS/multi | < 10% 10%–19.99% ≥ 20% |
Ref. 0.97 (0.87-1.10) 0.90 (0.73-1.10) |
- | ||||
| OS/uni | < 10% 10%–19.99% ≥ 20% |
Ref. 1.27 (1.19-1.35)∗ 1.50 (1.38-1.62)∗ |
Poverty level higher than 10% | ||||
| OS/multi | < 10% 10%–19.99% ≥ 20% |
Ref. 1.04 (0.95-1.13) 1.05 (0.91-1.22) |
- | ||||
| Byrne et al,35 (2011) | FCDS 1998-2002 |
FL | AML 4659 |
OS/multi | ≤ 5% 5.1%-10% 10.1%-15% > 15% |
Ref. 1.04 (0.97-1.14) 1.11 (1.00-1.22) 1.15 (1.04-1.27)∗ |
Poverty level higher than 15% |
| Freeman et al,32 (2016) | NC CCR 2003-2009 |
NC | AML 900 |
OS/multi | NS | 0.99 (0.98-1.01) | - |
| Perry et al,16 (2017) | SEER 2007-2012 |
National | CML 15-64 y.o. 3626 |
OS/multi | Below median Above median |
Ref. 1.03 (0.69-1.54) |
- |
| CML ≥ 65 y.o. 2142 |
OS/multi | Below median Above median |
Ref. 1.06 (0.83-1.36) |
- | |||
| Unemployment rate | |||||||
| Freeman et al,32 (2016) | NC CCR 2003-2009 |
NC | AML. 900 |
OS/multi | NS | 0.99 (0.97-1.02) | - |
| Perry et al,16 (2017) | SEER 2007-2012 |
National | CML.15-64 y.o. 3626 |
OS/multi | Below median Above median |
Ref. 1.01 (0.78-1.32) |
- |
| CML ≥ 65 y.o. 2142 |
OS/multi | Below median Above median |
Ref. 1.02 (0.86-1.20) |
- | |||
ALL, acute lymphoblastic lymphoma, AML, acute myeloid leukemia; APL, acute promyelocytic leukemia; CA, California; CCR, California Cancer Registry; CI, confidential interval; CIBMTR, Center for International Blood and Marrow Transplant Research; CML, chronic myeloid leukemia; CSS, cancer-specific survival; CTX, chemotherapy; DFS, disease-free survival; FCDS, Florida Cancer Data System; FL, Florida; HL, Hodgkin lymphoma; HR, hazard ratio; MDS, myelodysplastic syndromes; MO, Missouri; MM, multiple myeloma; multi, multivariate analysis; N, sample size; NC, North Carolina; NCDB, National Cancer Database; NC CCR, North Carolina Central Cancer Registry; NE, Nebraska; NHL, Nnn-Hodgkin Lymphoma; NS, not specified; OH, Ohio; OR, odds ratio; P-bone, plasmacytoma originating in bone; P-EM, plasmacytoma originating in extramedullary; PM, plasmacytoma; Ref., reference; SES, socioeconomic status; SEER, Surveillance, Epidemiology, and End Results Registry; TRM, transplant-related mortality; uni, univariate analysis; UNMC, University of Nebraska Medical Center Oncology Database; VA, Virginia; VCR, Virginia Cancer Registry; VHI, Virginia Health Information; WM, Waldenstrom macroglobulinemia; y.o., years old.
∗
Reported as statistical significance by the author.
†
Statistical significance but not discussed by the author.
‡
Not specified values.