{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T03:12:41Z","timestamp":1793243561383,"version":"4.5.0"},"reference-count":43,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi240070-4\"><jats:title>Importance<\/jats:title><jats:p>In recent years, there has been a focus on reducing the socioeconomic gap in survival for hematological malignant neoplasms. Understanding recent developments is important to develop further intervention to improve care.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240070-5\"><jats:title>Objective<\/jats:title><jats:p>To investigate the temporal trend in associations of socioeconomic status (SES) with survival among 3 aggressive hematological malignant neoplasms: multiple myeloma (MM), acute myeloid leukemia (AML), and diffuse large B-cell lymphoma (DLBCL).<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240070-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This nationwide, population-based cohort study used retrospectively collected data from 3 clinical registries of patients diagnosed in Denmark between January 1, 2005, and December 31, 2020, with follow-up until December 31, 2021. Analyses were stratified by diagnosis year (2005-2009, 2010-2014, and 2015-2020). Participants were patients aged 25 to 65 years with hematological malignant neoplasms. Patients with missing data on education were excluded. Data were analyzed from October 14, 2022, to January 2, 2024.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240070-7\"><jats:title>Exposure<\/jats:title><jats:p>Education was used as a proxy for SES and defined low- and high-SES groups based on the completion of tertiary education.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240070-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The main outcome was overall survival (OS), analyzed using Kaplan-Meier (log rank) method and Cox proportional hazards regression adjusted for age, sex, performance status, comorbidities, and disease-specific prognostic indices. Two-year OS through time and survival difference were estimated using flexible parametric survival models.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240070-9\"><jats:title>Results<\/jats:title><jats:p>A total of 5677 patients (median [IQR] age, 58 [51-62] years; 3177 [57.0%] male) were assessed, including 1826 patients with MM, 1236 patients with AML, and 2509 patients with DLBCL. The 2-year OS increased over time for patients with MM (78.8% [95% CI, 75.4%-82.3%] to 91.4% [95% CI, 89.3%-93.5%]), AML (42.2% [95% CI, 37.8%-47.1%] to 52.7% [95% CI, 48.0%-57.9%]), and DLBCL (80.1% [95% CI, 77.4%-82.8%] to 88.1% [95% CI, 86.0%-90.3%]). For MM and DLBCL, no association of SES with survival was observed after adjustment (MM: hazard ratio [HR], 0.99 [95% CI, 0.85-1.15]; DLBCL: HR, 1.08 [95% CI, 0.91-1.29]). For AML, a negative association was observed between low SES and survival (HR, 1.49 [95% CI, 1.25-1.76]), but the association was attenuated in recent years. The difference in hazard for patients with low SES and AML was observed in the first 2 years after diagnosis.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240070-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>These findings suggest that survival has improved among patients with these hematological malignant neoplasms. While patients with MM and DLBCL had increased survival in all groups, disparities were observed in AML outcomes, primarily in the first years after diagnosis. These results suggest that differences originate in factors specific to AML.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.1112","type":"journal-article","created":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T16:01:15Z","timestamp":1709568075000},"page":"e241112","source":"Crossref","is-referenced-by-count":23,"title":["Socioeconomic Status and Overall Survival Among Patients With Hematological Malignant Neoplasms"],"prefix":"10.1001","volume":"7","author":[{"given":"Lars Hern\u00e1ndez","family":"Nielsen","sequence":"first","affiliation":[{"name":"Center for Clinical Data Science, Department of Clinical Medicine, Aalborg University and Research, Education and Innovation, Aalborg University Hospital, Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Tuyet","family":"Kristensen","sequence":"additional","affiliation":[{"name":"Center for Clinical Data Science, Department of Clinical Medicine, Aalborg University and Research, Education and Innovation, Aalborg University Hospital, Aalborg, Denmark"},{"name":"Department of Hematology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lasse Hjort","family":"Jakobsen","sequence":"additional","affiliation":[{"name":"Department of Hematology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark"},{"name":"Department of Clinical Medicine, Aalborg University, Aalborg, Denmark"},{"name":"Department of Mathematical Sciences, Aalborg University, Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"B\u00f8gsted","sequence":"additional","affiliation":[{"name":"Center for Clinical Data Science, Department of Clinical Medicine, Aalborg University and Research, Education and Innovation, Aalborg University Hospital, Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"Gregersen","sequence":"additional","affiliation":[{"name":"Department of Hematology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakob","family":"Madsen","sequence":"additional","affiliation":[{"name":"Department of Hematology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne Tang","family":"Severinsen","sequence":"additional","affiliation":[{"name":"Department of Hematology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark"},{"name":"Department of Clinical Medicine, Aalborg University, Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rasmus Froberg","family":"Br\u00f8ndum","sequence":"additional","affiliation":[{"name":"Center for Clinical Data Science, Department of Clinical Medicine, Aalborg University and Research, Education and Innovation, Aalborg University Hospital, Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2024,3,4]]},"reference":[{"issue":"5","key":"zoi240070r1","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1080\/0284186X.2019.1566772","article-title":"Socioeconomic inequality in cancer survival\u2014changes over time: a population-based study, Denmark, 1987-2013.","volume":"58","author":"Dalton","year":"2019","journal-title":"Acta Oncol"},{"key":"zoi240070r2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.854659","article-title":"Editorial: social inequality in cancer screening.","volume":"10","author":"Van Hal","year":"2022","journal-title":"Front Public Health"},{"issue":"2","key":"zoi240070r3","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001376","article-title":"Socioeconomic inequalities in lung cancer treatment: systematic review and meta-analysis.","volume":"10","author":"Forrest","year":"2013","journal-title":"PLoS Med"},{"issue":"5","key":"zoi240070r4","doi-asserted-by":"publisher","first-page":"536","DOI":"10.1200\/JCO.2012.45.4553","article-title":"Patient income level and cancer clinical trial participation.","volume":"31","author":"Unger","year":"2013","journal-title":"J Clin Oncol"},{"issue":"32","key":"zoi240070r5","doi-asserted-by":"publisher","first-page":"3678","DOI":"10.1200\/JCO.2017.73.6728","article-title":"Effects of education and income on treatment and outcome in patients with acute myeloid leukemia in a tax-supported health care system: a national population-based cohort study.","volume":"35","author":"\u00d8stg\u00e5rd","year":"2017","journal-title":"J Clin Oncol"},{"issue":"11","key":"zoi240070r6","doi-asserted-by":"publisher","first-page":"1317","DOI":"10.1080\/0284186X.2022.2143278","article-title":"Socioeconomic inequality in cancer in the Nordic countries. a systematic review.","volume":"61","author":"Ammitzb\u00f8ll","year":"2022","journal-title":"Acta Oncol"},{"issue":"12","key":"zoi240070r7","doi-asserted-by":"publisher","first-page":"2073","DOI":"10.1200\/JCO.2008.18.2006","article-title":"Socioeconomic differences in patient survival are increasing for acute myeloid leukemia and multiple myeloma in Sweden.","volume":"27","author":"Kristinsson","year":"2009","journal-title":"J Clin Oncol"},{"issue":"5","key":"zoi240070r8","doi-asserted-by":"publisher","first-page":"988","DOI":"10.1038\/bjc.2012.3","article-title":"Socioeconomic position, treatment, and survival of non-Hodgkin lymphoma in Denmarkm\u2014a nationwide study.","volume":"106","author":"Frederiksen","year":"2012","journal-title":"Br J Cancer"},{"key":"zoi240070r9","doi-asserted-by":"publisher","first-page":"583","DOI":"10.2147\/CLEP","article-title":"The Danish national multiple myeloma registry.","volume":"8","author":"Gimsing","year":"2016","journal-title":"Clin Epidemiol"},{"issue":"1","key":"zoi240070r10","doi-asserted-by":"publisher","first-page":"335","DOI":"10.2147\/CLEP","article-title":"Data quality in the Danish National Acute Leukemia Registry: a hematological data resource.","volume":"5","author":"Ostg\u00e5rd","year":"2013","journal-title":"Clin Epidemiol"},{"issue":"6","key":"zoi240070r11","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0157999","article-title":"The Danish National Lymphoma Registry: coverage and data quality.","volume":"11","author":"Arboe","year":"2016","journal-title":"PLoS One"},{"issue":"15","key":"zoi240070r12","doi-asserted-by":"publisher","first-page":"3412","DOI":"10.1200\/JCO.2005.04.242","article-title":"International Staging System for Multiple Myeloma.","volume":"23","author":"Greipp","year":"2005","journal-title":"J Clin Oncol"},{"issue":"3","key":"zoi240070r13","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1182\/blood-2009-11-254441","article-title":"Refinement of cytogenetic classification in acute myeloid leukemia: determination of prognostic significance of rare recurring chromosomal abnormalities among 5876 younger adult patients treated in the United Kingdom Medical Research Council trials.","volume":"116","author":"Grimwade","year":"2010","journal-title":"Blood"},{"issue":"14","key":"zoi240070r14","doi-asserted-by":"publisher","first-page":"987","DOI":"10.1056\/NEJM199309303291402","article-title":"A predictive model for aggressive non-Hodgkin\u2019s lymphoma.","volume":"329","author":"International Non-Hodgkin\u2019s Lymphoma Prognostic Factors Project","year":"1993","journal-title":"N Engl J Med"},{"issue":"7","key":"zoi240070r15","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1177\/1403494810394715","article-title":"Danish education registers.","volume":"39","author":"Jensen","year":"2011","journal-title":"Scand J Public Health"},{"issue":"1","key":"zoi240070r16","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1097\/EDE.0b013e3181c1ea43","article-title":"The hazards of hazard ratios.","volume":"21","author":"Hern\u00e1n","year":"2010","journal-title":"Epidemiology"},{"issue":"4","key":"zoi240070r18","doi-asserted-by":"publisher","first-page":"989","DOI":"10.1002\/bimj.v62.4","article-title":"Generalized parametric cure models for relative survival.","volume":"62","author":"Jakobsen","year":"2020","journal-title":"Biom J"},{"issue":"9","key":"zoi240070r20","doi-asserted-by":"publisher","first-page":"2643","DOI":"10.3109\/10428194.2015.1011156","article-title":"Socioeconomic status is independently associated with overall survival in patients with multiple myeloma.","volume":"56","author":"Fiala","year":"2015","journal-title":"Leuk Lymphoma"},{"issue":"4","key":"zoi240070r21","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/cancers13040590","article-title":"Socioeconomic factors and survival of multiple myeloma patients.","volume":"13","author":"Chamoun","year":"2021","journal-title":"Cancers (Basel)"},{"issue":"1","key":"zoi240070r22","doi-asserted-by":"publisher","DOI":"10.4084\/mjhid.2021.006","article-title":"Socioeconomic status is globally a prognostic factor for overall survival of multiple myeloma patients: synthesis of studies and review of the literature.","volume":"13","author":"Intzes","year":"2021","journal-title":"Mediterr J Hematol Infect Dis"},{"issue":"8","key":"zoi240070r23","doi-asserted-by":"publisher","first-page":"1277","DOI":"10.2105\/AJPH.90.8.1277","article-title":"Socioeconomic status and multiple myeloma among US blacks and whites.","volume":"90","author":"Baris","year":"2000","journal-title":"Am J Public Health"},{"issue":"1","key":"zoi240070r24","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1080\/10428194.2017.1335398","article-title":"Improved survival in multiple myeloma, with a diminishing racial gap and a widening socioeconomic status gap over three decades.","volume":"59","author":"Sun","year":"2018","journal-title":"Leuk Lymphoma"},{"issue":"9","key":"zoi240070r25","doi-asserted-by":"publisher","first-page":"1021","DOI":"10.1007\/s10552-021-01454-w","article-title":"Differences in survival among multiple myeloma patients in the United States SEER population by neighborhood socioeconomic status and race\/ethnicity.","volume":"32","author":"Casta\u00f1eda-Avila","year":"2021","journal-title":"Cancer Causes Control"},{"issue":"11","key":"zoi240070r26","doi-asserted-by":"publisher","first-page":"3231","DOI":"10.1002\/cncr.v113:11","article-title":"Ethnic variations in diagnosis, treatment, socioeconomic status, and survival in a large population-based cohort of elderly patients with non-Hodgkin lymphoma.","volume":"113","author":"Wang","year":"2008","journal-title":"Cancer"},{"issue":"5","key":"zoi240070r27","doi-asserted-by":"publisher","first-page":"883","DOI":"10.1002\/ijc.v142.5","article-title":"Lower socioeconomic status is independently associated with shorter survival in Hodgkin Lymphoma patients\u2014an analysis from the Brazilian Hodgkin Lymphoma Registry.","volume":"142","author":"Biasoli","year":"2018","journal-title":"Int J Cancer"},{"issue":"4","key":"zoi240070r28","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1111\/joim.2019.285.issue-4","article-title":"Impact of comorbidity on disease characteristics, treatment intent and outcome in diffuse large B-cell lymphoma: a Swedish lymphoma register study.","volume":"285","author":"W\u00e4sterlid","year":"2019","journal-title":"J Intern Med"},{"issue":"11","key":"zoi240070r29","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-049087","article-title":"Association between multimorbidity and socioeconomic deprivation on short-term mortality among patients with diffuse large B-cell or follicular lymphoma in England: a nationwide cohort study.","volume":"11","author":"Smith","year":"2021","journal-title":"BMJ Open"},{"key":"zoi240070r30","doi-asserted-by":"publisher","DOI":"10.1155\/2010\/824691","article-title":"Socioeconomic impacts on survival differ by race\/ethnicity among adolescents and young adults with non-Hodgkin\u2019s lymphoma.","volume":"2010","author":"Kent","year":"2010","journal-title":"J Cancer Epidemiol"},{"issue":"2","key":"zoi240070r31","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1089\/jayao.2014.0037","article-title":"Survival differences by race\/ethnicity and neighborhood socioeconomic status in adolescents and young adults diagnosed with non-Hodgkin lymphoma.","volume":"4","author":"Chao","year":"2015","journal-title":"J Adolesc Young Adult Oncol"},{"issue":"8","key":"zoi240070r32","doi-asserted-by":"publisher","first-page":"1153","DOI":"10.1007\/s10552-015-0609-1","article-title":"US trends in survival disparities among adolescents and young adults with non-Hodgkin lymphoma.","volume":"26","author":"Kent","year":"2015","journal-title":"Cancer Causes Control"},{"key":"zoi240070r33","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1016\/j.canep.2017.04.009","article-title":"No outcome disparities in patients with diffuse large B-cell lymphoma and a low socioeconomic status.","volume":"48","author":"Boslooper","year":"2017","journal-title":"Cancer Epidemiol"},{"key":"zoi240070r34","doi-asserted-by":"publisher","DOI":"10.1016\/j.canep.2020.101699","article-title":"Socioeconomic deprivation is associated with decreased survival in patients with acute myeloid leukemia.","volume":"66","author":"Le Floch","year":"2020","journal-title":"Cancer Epidemiol"},{"issue":"8","key":"zoi240070r35","doi-asserted-by":"publisher","first-page":"1703","DOI":"10.1007\/s00277-022-04862-3","article-title":"Relapse surveillance of acute myeloid leukemia patients in first remission after consolidation chemotherapy: diagnostic value of regular bone marrow aspirations.","volume":"101","author":"Koschade","year":"2022","journal-title":"Ann Hematol"},{"issue":"12","key":"zoi240070r36","doi-asserted-by":"publisher","first-page":"2756","DOI":"10.1002\/cncr.v110:12","article-title":"Potential cure of acute myeloid leukemia: analysis of 1069 consecutive patients in first complete remission.","volume":"110","author":"Yanada","year":"2007","journal-title":"Cancer"},{"issue":"5","key":"zoi240070r37","doi-asserted-by":"publisher","first-page":"791","DOI":"10.1111\/bjh.2017.177.issue-5","article-title":"Early mortality and complications in hospitalized adult Californians with acute myeloid leukaemia.","volume":"177","author":"Ho","year":"2017","journal-title":"Br J Haematol"},{"issue":"11","key":"zoi240070r38","doi-asserted-by":"publisher","first-page":"4171","DOI":"10.1007\/s00520-019-04701-8","article-title":"Impact of time to antibiotic on hospital stay, intensive care unit admission, and mortality in febrile neutropenia.","volume":"27","author":"Daniels","year":"2019","journal-title":"Support Care Cancer"},{"key":"zoi240070r39","doi-asserted-by":"publisher","first-page":"769","DOI":"10.2147\/CLEP","article-title":"Longer distance to specialized treatment centers does not adversely affect treatment intensity or outcomes in adult acute myeloid leukemia patients: a Danish national population-based cohort study.","volume":"11","author":"T\u00f8stesen","year":"2019","journal-title":"Clin Epidemiol"},{"issue":"4","key":"zoi240070r40","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0174760","article-title":"Sociodemographic disparities in chemotherapy and hematopoietic cell transplantation utilization among adult acute lymphoblastic and acute myeloid leukemia patients.","volume":"12","author":"Jabo","year":"2017","journal-title":"PLoS One"},{"issue":"2","key":"zoi240070r41","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1111\/bjh.v190.2","article-title":"The prognostic effect of smoking status on intensively treated acute myeloid leukaemia\u2014a Danish nationwide cohort study.","volume":"190","author":"Kristensen","year":"2020","journal-title":"Br J Haematol"},{"issue":"January","key":"zoi240070r42","doi-asserted-by":"publisher","DOI":"10.1016\/j.leukres.2021.106567","article-title":"The prognostic impact of anthropometrics in acute myeloid leukemia treated with intensive chemotherapy\u2014a Danish nationwide cohort study.","volume":"106","author":"Kristensen","year":"2021","journal-title":"Leuk Res"},{"issue":"1","key":"zoi240070r43","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1111\/ejh.2016.97.issue-1","article-title":"A high BMI is a risk factor in younger patients with de novo acute myelogenous leukemia.","volume":"97","author":"Crysandt","year":"2016","journal-title":"Eur J Haematol"},{"key":"zoi240070r17","unstructured":"Kassambara? A, Kosinski? M, Biecek? P. survminer: drawing survival curves using \u2018ggplot2\u2019. Accessed January 25, 2024. https:\/\/cran.r-project.org\/web\/packages\/survminer\/"},{"key":"zoi240070r19","unstructured":"Dayimu? A. forestploter: create flexible forest plot. Accessed January 25, 2024. https:\/\/cran.r-project.org\/web\/packages\/forestploter\/forestploter.pdf"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2815524\/nielsen_2024_oi_240070_1708462045.23188.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T16:01:19Z","timestamp":1709568079000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2815524"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,4]]},"references-count":43,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,3,4]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2024.1112","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,4]]}}}