A systematic review identified 5 different social determinants of health (SDH) that negatively affected the clinical outcomes of patients with hematologic malignancies.
“Our proposal is to include the SDH that we know impact prognosis and take into consideration to plan the patient’s treatment,” Marisol Miranda-Galvis, PhD, of the Georgia Cancer Center in Augusta, Georgia, said when presenting the study results at the SOHO 2023 Annual Meeting.
The systematic review analyzed data from 24,353 patients with a hematologic malignancy from 41 studies. There were 134 SDH included in the studies, with the most common including healthcare access, economic stability, education access, and social context.
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There were 5 SDH that were significantly associated with worse outcomes, including public insurance or lack of insurance, cancer care at a nonacademic center, low household income, low education level, and unmarried status.
There were 74% of studies for which insurance status was significantly associated with survival outcomes in a multivariate analysis. For social context, all studies found that marital status was also significantly associated with survival outcomes.
In the category of economic stability, 62% of studies found a significant association between income and survival. High school education level was also associated with survival in 44% of studies; however, 37% of studies showed no association.
Although facility volume, provider expertise, poverty, and employment rates were examined, there were a limited number of studies, making interpretation difficult.
“An interesting finding was the lack of data,” Dr Miranda-Galvis said. “There is need to research directly for SDH and research that is using patient-level data.”
Reference
Miranda-Galvis M, Tjio K, Balas A, et al. Cancer disparities in survival of patients with hematologic malignancies in the context of social determinants of health: a systematic review. Presented at: the Eleventh Annual Meeting of the Society of Hematologic Oncology (SOHO); September 6-9, 2023. MDS-044.
