European Journal of Epidemiology ( IF 7.7 ) Pub Date : 2024-07-04 , DOI: 10.1007/s10654-024-01139-z Joachim Baech 1, 2 , Lasse Hjort Jakobsen 1 , Mikkel Runason Simonsen 1 , Marianne Tang Severinsen 1, 2 , Henrik Frederiksen 3, 4 , Carsten Utoft Niemann 5 , Peter Brown 5 , Judit Mészáros Jørgensen 6 , Eldad J Dann 7 , Søren Paaske Johnsen 8 , Tarec Christoffer El-Galaly 1, 2, 3, 9
Overall survival (OS) for patients with a hematological cancer may differ between immigrant and Danish-born patients due to disparities in socioeconomic status, health literacy, and language proficiency. This cohort study aimed to investigate survival and hospitalization according to immigrant status while controlling for confounders. Patients with newly diagnosed hematological cancer in 2000–2020 were identified in the Danish nationwide hematological registers and stratified into Danish-born, Western, and non-Western patients. Patients were followed from diagnosis until death, 31st December 2021, or emigration, whichever came first. Crude OS, standardized OS, and 5-years OS differences were computed using flexible parametric models and hazard ratios using Cox regression. Number of hospitalization days in the year before and after diagnosis, respectively, were calculated using Poisson regression. A total of 2,241 immigrants and 41,519 Danish-born patients with a hematological cancer were included. Standardized 5-years OS was similar between groups with 58% (95% confidence interval 57–58%) for Danish-born patients, 57% (55–60%) for Western, and 56% (53–58%) for non-Western immigrant patients. Subgroup analyses identified OS differences in selected subgroups. Non-Western immigrant patients had 1.3 (0.5–2.1) more hospitalization days in the year before diagnosis and an adjusted incidence rate ratio of hospitalization days of 1.14 (1.13–1.15) in the year after diagnosis compared with Danish-born patients. In conclusion, there were no overall differences in survival when comparing immigrant patients to Danish-born patients after controlling for relevant confounders. Healthcare utilization was slightly higher among non-Western immigrant patients before and after diagnosis, but differences were small on an individual patient level.
中文翻译:
移民患者与丹麦出生的血液癌症患者之间的生存结果和医疗保健利用:一项基于丹麦人口的研究
由于社会经济地位、健康素养和语言能力的差异,移民和丹麦出生的血液癌症患者的总生存期 (OS) 可能有所不同。这项队列研究旨在根据移民身份调查生存率和住院率,同时控制混杂因素。丹麦全国血液学登记册中确定了 2000 年至 2020 年新诊断的血液癌症患者,并将其分为丹麦出生的患者、西方患者和非西方患者。从诊断开始对患者进行随访,直至 2021 年 12 月 31 日死亡或移居国外,以先到者为准。使用灵活的参数模型和使用 Cox 回归的风险比计算粗略 OS、标准化 OS 和 5 年 OS 差异。使用泊松回归分别计算诊断前和诊断后一年的住院天数。总共包括 2,241 名移民和 41,519 名丹麦出生的血液癌症患者。标准化 5 年 OS 组间相似,丹麦出生的患者为 58%(95% 置信区间 57-58%),西方患者为 57%(55-60%),非出生患者为 56%(53-58%)。 -西方移民患者。亚组分析确定了选定亚组中的 OS 差异。与丹麦出生的患者相比,非西方移民患者在诊断前一年的住院天数多 1.3(0.5-2.1),诊断后一年住院天数的调整后发生率比为 1.14(1.13-1.15)。总之,在控制相关混杂因素后,将移民患者与丹麦出生的患者进行比较时,生存率没有总体差异。 非西方移民患者在诊断前后的医疗保健利用率略高,但个体患者水平上的差异很小。