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Association between insurance and socioeconomic status and risk of advanced stage Hodgkin lymphoma in adolescents and young adults†
Article first published online: 26 JUN 2012
Copyright © 2012 American Cancer Society
Volume 118, Issue 24, pages 6179–6187, 15 December 2012
How to Cite
Smith, E. C., Ziogas, A. and Anton-Culver, H. (2012), Association between insurance and socioeconomic status and risk of advanced stage Hodgkin lymphoma in adolescents and young adults. Cancer, 118: 6179–6187. doi: 10.1002/cncr.27684
See editorial on pages 6018–21, this issue.
- Issue published online: 3 DEC 2012
- Article first published online: 26 JUN 2012
- Manuscript Accepted: 1 FEB 2012
- Manuscript Revised: 6 JAN 2012
- Manuscript Received: 29 AUG 2011
- Hodgkin lymphoma;
- adolescents and young adults;
- advanced stage;
- health insurance;
- socioeconomic status
Hodgkin lymphoma (HL) is one of the most common types of cancer among adolescents and young adults (AYAs) in the United States. Unfortunately, a greater percentage of AYAs are presenting with an advanced stage of disease at the time of diagnosis compared with their younger counterparts.
The objective of the current study was to examine the association between possible barriers and characteristics (including gender, race, birthplace, marital status, socioeconomic status [SES], and insurance status) that may increase the risk of advanced stage HL at the time of diagnosis in a large cohort of AYA patients with HL from the California Cancer Registry (7343 incident cases of HL diagnosed from 1988-2006, between ages 15 years-40 years).
AYAs with advanced stage HL were more likely to be male, of Hispanic or black race/ethnicity, foreign born, single, of lower SES, and uninsured or to have only public health insurance (P < .05). Multivariate logistic regression analysis demonstrated that there was a significant increase in the odds of having advanced HL in males (odds ratio [OR], 1.57; 95% confidence interval [95% CI], 1.42-1.74 [P < .0001]), those with the lowest SES (OR, 1.47; 95% CI, 1.23-1.75 [P = .0003]), those without health insurance (OR, 1.76; 95% CI, 1.34-2.31 [P < .0001]), and those with public health insurance (OR, 1.45; 95% CI, 1.23-1.71 [P < .0001]).
A strong association was found between male gender, lower SES, and lack of health insurance and advanced stage HL at the time of diagnosis in AYAs (See editorial on pages 000–000, this issue.) Cancer 2012. © 2012 American Cancer Society.