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Socioeconomic Status and Chemotherapy Use for Melanoma in Older People*

  • Carlos A. Reyes-Ortiz (a1), James S. Goodwin (a2), Dong D. Zhang (a2) and Jean L. Freeman (a2)

Abstract

The study objective was to examine the association, among older persons with cutaneous melanoma, between areal socioeconomic status (SES) and receiving chemotherapy. SEER-Medicare-linked database (1,239 white men and women aged ≥ 66, with invasive melanoma [regional and distant stages]; 1991–1999) was used. SES was measured by census tract poverty level (average of 1990 and 2000 Census data). Covariates were sociodemographics, tumor characteristics, and comorbidity index. Residing in poorer SES areas was associated with a lower likelihood for receiving chemotherapy among patients in the overall sample (adjusted odds ratios = OR 0.97, 95% confidence interval = CI 0.95–0.99), and those with regional stage at diagnosis (OR 0.97, 95% CI 0.94–0.98). These findings reflect socioeconomic disparities in chemotherapy use for melanoma among older white patients in the United States.

L’objectif de cette étude était d’examiner l’association entre la zone de statut socio-économique (SSE) et recevant une chimiothérapie chez les personnes âgées atteints de mélanome cutané. Une base de données liée à SEER-Medicare (1.329 hommes et femmes blancs âgés de ≥ 66, avec des étapes de mélanome invasif [régionaux et éloignés]; 1991-1999) a été utilisé. SSE a été mesurée par le niveau de pauvreté des secteurs de recensement (moyenne de 1990 et 2000 des données du recensement). Covariables ont été données sociodémographiques, caractéristiques de la tumeur et l’indice de comorbidité. Résidant dans les régions les plus pauvres SES a été associée à une faible probabilité de recevoir une chimiothérapie chez les patients de l’échantillon global (odds ratios ajustés = ou 0,97, intervalle de confiance IC 95% = 0.95 à 0.99), et ceux au stade régional au moment du diagnostic (OR 0,97, IC à 95% de 0.94 à 0.98). Ces résultats reflètent les disparités socio-économiques dans l’utilisation de chimiothérapie pour le mélanome chez les patients âgés blancs aux Etats-Unis.

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Corresponding author

Correspondence and requests for offprints should be sent to / La correspondance et les demandes de tirés-à-part doivent être adressées à: Carlos A. Reyes-Ortiz, M.D., Ph.D. Department of Social & Behavioral Sciences School of Public Health University of North Texas Health Science Center 3500 Camp Bowie Boulevard (EAD-711B) Fort Worth, TX 76107-2699 (carlos.reyesortiz@unthsc.edu)

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*

This work was supported by the Agency of Healthcare Research and Quality (R24 HS011618-04) and by the National Cancer Institute (University of Texas Medical Branch, Center on Population Health and Health Disparities – P50CA105631).

Footnotes

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Keywords

Socioeconomic Status and Chemotherapy Use for Melanoma in Older People*

  • Carlos A. Reyes-Ortiz (a1), James S. Goodwin (a2), Dong D. Zhang (a2) and Jean L. Freeman (a2)

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