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Regional difference...
Regional differences in treatment and outcome for myeloma patients in Sweden : A population based Swedish myeloma register study
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- Wålinder, Göran (author)
- Karolinska Institutet,Karolinska Institute,Karolinska University Hospital,Karolinska Inst, Sweden; Karolinska Univ Hosp Huddinge, Sweden
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- Genell, Anna (author)
- Regional Cancer Center Western Sweden,Reg Canc Ctr West, Sweden
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- Juliusson, Gunnar (author)
- Lund University,Lunds universitet,Stamcellscentrum (SCC),Avdelningen för stamcellsforskning,Institutionen för laboratoriemedicin,Medicinska fakulteten,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Stem Cell Center,Division of stem cell research,Department of Laboratory Medicine,Faculty of Medicine,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Lund Univ, Sweden
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- Svensson, Ronald (author)
- Linköping University Hospital,Region Östergötland, Hematologiska kliniken US
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- Santamaria, Antonio Izarra (author)
- Norrland University Hospital,Umea Univ Hosp, Sweden
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- Crafoord, Jacob (author)
- Örebro University Hospital,Orebro Univ Hosp, Sweden
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- Carlson, Kristina (author)
- Uppsala University Hospital,Uppsala Univ Hosp, Sweden
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- Knut-Bojanowska, Dorota (author)
- Norra Älvsborgs Länssjukhus,Uddevalla Cent Hosp, Sweden
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- Veskovski, Ljupco (author)
- The County of Västra Götaland,Sodra Alvsborgs Hosp, Sweden
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- Lauri, Birgitta (author)
- Sunderby Hospital,Sundeby Hosp, Sweden
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- Lund, Johan (author)
- Karolinska Institutet,Karolinska Institute,Karolinska University Hospital,Karolinska Inst, Sweden; Karolinska Univ Hosp Huddinge, Sweden
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- Turesson, Ingemar (author)
- Skåne University Hospital,Skane Univ Hosp, Sweden
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- Hansson, Markus (author)
- Sahlgrenska University Hospital,Sahlgrens Univ Hosp, Sweden
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- Blimark, Cecilie Hveding (author)
- Sahlgrenska University Hospital,Sahlgrens Univ Hosp, Sweden
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- Nahi, Hareth (author)
- Karolinska Institutet,Karolinska Institute,Karolinska University Hospital,Karolinska Inst, Sweden; Karolinska Univ Hosp Huddinge, Sweden
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(creator_code:org_t)
- 2022-03-03
- 2022
- English.
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In: Cancer Reports. - : Wiley. - 2573-8348. ; 5:11
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Abstract
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- Background: We wanted to evaluate if health care for multiple myeloma (MM) patients is equal in different regions of Sweden. Aim: To study differences in survival for MM depending on health care region and early use of modern treatment. Methods and results: Data from the Swedish Myeloma Register from patients diagnosed between 2008 and 2017 was used. Cohorts were defined by the six healthcare regions (labeled A–F) in Sweden and modern initial treatment was defined as including certain drug combinations. To adjust for time to treatment bias, survival analyses were performed also for patients alive 6 months after diagnosis. In all treated MM patients (n = 5326), we observed a superior overall survival (OS) for region A compared to all other regions (p <.01 for all respectively). After adjusting for time to treatment there was also a superior survival in the region with highest use of modern initial treatment (region A) compared to the regions defined in the study as having intermediate and low use (p <.01 for both). In patients receiving autologous stem cell transplantation (ASCT) a superior survival was observed for region A compared to all regions besides region B. Similar results were seen when adjusting for a time to treatment bias. In patients not receiving ASCT, 75 years or older and adjusted for time to treatment bias, a difference was noted only between region A and E (log rank p =.04, HR 1.2, CI 1.00–1.44, p =.06). In multivariate analyses including age, international staging system stage and time period of diagnosis, differences in survival remained for patients receiving ASCT between region A versus C, D, E and F (p =.01, p <.01, p <.01, p =.03). Conclusion: We observed a superior survival in region A for patients receiving ASCT. Explanations may be higher usage of modern initial treatment or regional residual confounding. For patients not receiving ASCT, 75 years or older, differences in survival could be adjusted for.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Health Care Service and Management, Health Policy and Services and Health Economy (hsv//eng)
Keyword
- cancer care
- epidemiology
- multiple myeloma
- treatment outcome
- cancer care; epidemiology; multiple myeloma; treatment outcome
Publication and Content Type
- art (subject category)
- ref (subject category)
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- By the author/editor
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Wålinder, Göran
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Genell, Anna
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Juliusson, Gunna ...
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Svensson, Ronald
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Santamaria, Anto ...
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Crafoord, Jacob
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Carlson, Kristin ...
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Knut-Bojanowska, ...
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Veskovski, Ljupc ...
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Lauri, Birgitta
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Lund, Johan
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Turesson, Ingema ...
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Hansson, Markus
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Blimark, Cecilie ...
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Nahi, Hareth
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cancer and Oncol ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Health Sciences
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- Articles in the publication
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Cancer Reports
- By the university
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Lund University
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Linköping University
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Karolinska Institutet