Table 3:
Relation of treatment at NCI-DCC to ACA implementation period, and clinical and sociodemographic factors among adolescents and young adults with lymphomas, California, 2005–2017
| All patients N=11,337 |
Non-Hodgkin lymphoma N=5,959 |
Hodgkin lymphoma N=5,378 |
|
|---|---|---|---|
|
| |||
| Characteristics (N=11,337) | aOR (95% CI) | aOR (95% CI) | aOR (95% CI) |
| Calendar period | |||
| Pre-ACA (Mar 2005–Sep 2010) | Reference | Reference | Reference |
| Early ACA (Oct 2010–Dec 2013) | 1.26 (1.13–1.41) | 1.33 (1.15–1.53) | 1.21 (1.03–1.42) |
| Full ACA (Jan 2014–Dec 2017) | 1.42 (1.28–1.57) | 1.39 (1.21–1.60) | 1.47 (1.26–1.72) |
| Insurance& | |||
| Private | Reference | Reference | |
| Continuous Medicaid | 1.20 (1.05–1.36) | 1.24 (1.05–1.48) | 1.14 (0.93–1.39) |
| Discontinuous Medicaid | 1.38 (1.19–1.61) | 1.51 (1.24–1.84) | 1.23 (0.97–1.56) |
| Medicaid at diagnosis/uninsured | 1.51 (1.32–1.72) | 1.53 (1.28–1.83) | 1.47 (1.19–1.81) |
| Other Public* | 1.76 (1.21–2.56) | 1.37 (0.79–2.40) | 2.16 (1.30–3.57) |
| Age at diagnosis, years | |||
| 15–21 | Reference | Reference | Reference |
| 22–25 | 0.57 (0.50–0.65) | 0.57 (0.46–0.71) | 0.57 (0.48–0.68) |
| 26–39 | 0.49 (0.43–0.55) | 0.46 (0.38–0.55) | 0.53 (0.45–0.63) |
| Sex | |||
| Female | Reference | Reference | Reference |
| Male | 1.03 (0.95–1.13) | 1.10 (0.98–1.24) | 0.96 (0.85–1.10) |
| Race/ethnicity& | |||
| Non-Hispanic White | Reference | Reference | Reference |
| Non-Hispanic Black | 0.74 (0.62–0.89) | 0.69 (0.55–0.88) | 0.80 (0.61–1.06) |
| Hispanic | 0.91 (0.82–1.02) | 0.91 (0.78–1.05) | 0.93 (0.79–1.10) |
| Asian/Pacific Islander | 1.26 (1.10–1.43) | 1.25 (1.05–1.48) | 1.26 (1.02–1.56) |
| American Indian/Alaska Native | 1.39 (0.77–2.50) | 1.85 (0.89–3.83) | 0.75 (0.25–2.25) |
| Neighborhood SES | |||
| Highest | Reference | Reference | Reference |
| Middle | 0.64 (0.58–0.71) | 0.67 (0.58–0.77) | 0.62 (0.53–0.73) |
| Lowest | 0.60 (0.53–0.68) | 0.58 (0.49–0.68) | 0.64 (0.53–0.76) |
| Marital status& | |||
| Married | Reference | Reference | Reference |
| Not married | 1.04 (0.93–1.15) | 1.02 (0.89–1.17) | 1.04 (0.88–1.24) |
| Type of cancer | |||
| Hodgkin lymphoma | Reference | ||
| Non-Hodgkin lymphoma | 1.61 (1.46–1.77) | N/A | N/A |
| Charlson comorbidity Index& | |||
| None | Reference | Reference | Reference |
| One | 0.89 (0.76–1.04) | 0.89 (0.73–1.09) | 0.87 (0.68–1.11) |
| More than one | 1.31 (1.02–1.67) | 1.36 (1.03–1.80) | 1.04 (0.62–1.74) |
| Stage at diagnosis& | |||
| I | Reference | Reference | Reference |
| II | 1.16 (1.02–1.32) | 0.99 (0.84–1.17) | 1.48 (1.15–1.89) |
| III | 1.06 (0.91–1.23) | 0.93 (0.76–1.13) | 1.37 (1.04–1.79) |
| IV | 1.63 (1.43–1.84) | 1.55 (1.34–1.80) | 1.90 (1.44–2.49) |
Abbreviations: NCI-DCC, National Cancer Institute-Designated Cancer Center; SES, socioeconomic status; ACA, Affordable Care Act; aOR, adjusted odds ratios; CI, confidence interval; N/A, not applicable; Jan, January; Mar, March; Sep, September; Oct, October; Dec, December.
*
Other public includes Indian/Public Health Service, County Funded, not-otherwise specified (NOS), Medicare without supplement, Medicare, NOS.
&
Patients with unknown insurance, race/ethnicity, marital status, stage at diagnosis, and comorbidity are not shown in the Table.