{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T03:42:45Z","timestamp":1789530165335,"version":"build-2803163510"},"reference-count":75,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2021,11,19]],"date-time":"2021-11-19T00:00:00Z","timestamp":1637280000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000289","name":"Cancer Research UK","doi-asserted-by":"publisher","award":["C7923\/A18525"],"award-info":[{"award-number":["C7923\/A18525"]}],"id":[{"id":"10.13039\/501100000289","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>(1) Background: Socioeconomic inequalities of survival in patients with lymphoma persist, which may be explained by patients\u2019 comorbidities. We aimed to assess the association between comorbidities and the survival of patients diagnosed with diffuse large B-cell (DLBCL) or follicular lymphoma (FL) in England accounting for other socio-demographic characteristics. (2) Methods: Population-based cancer registry data were linked to Hospital Episode Statistics. We used a flexible multilevel excess hazard model to estimate excess mortality and net survival by patient\u2019s comorbidity status, adjusted for sociodemographic, economic, and healthcare factors, and accounting for the patient\u2019s area of residence. We used the latent normal joint modelling multiple imputation approach for missing data. (3) Results: Overall, 15,516 and 29,898 patients were diagnosed with FL and DLBCL in England between 2005 and 2013, respectively. Amongst DLBCL and FL patients, respectively, those in the most deprived areas showed 1.22 (95% confidence interval (CI): 1.18\u20131.27) and 1.45 (95% CI: 1.30\u20131.62) times higher excess mortality hazard compared to those in the least deprived areas, adjusted for comorbidity status, age at diagnosis, sex, ethnicity, and route to diagnosis. (4) Conclusions: Deprivation is consistently associated with poorer survival among patients diagnosed with DLBCL or FL, after adjusting for co\/multimorbidities. Comorbidities and multimorbidities need to be considered when planning public health interventions targeting haematological malignancies in England.<\/jats:p>","DOI":"10.3390\/cancers13225805","type":"journal-article","created":{"date-parts":[[2021,11,19]],"date-time":"2021-11-19T08:29:17Z","timestamp":1637310557000},"page":"5805","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Excess Mortality by Multimorbidity, Socioeconomic, and Healthcare Factors, amongst Patients Diagnosed with Diffuse Large B-Cell or Follicular Lymphoma in England"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8502-0056","authenticated-orcid":false,"given":"Matthew James","family":"Smith","sequence":"first","affiliation":[{"name":"Inequalities in Cancer Outcomes Network, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1410-5172","authenticated-orcid":false,"given":"Aur\u00e9lien","family":"Belot","sequence":"additional","affiliation":[{"name":"Inequalities in Cancer Outcomes Network, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Quartagno","sequence":"additional","affiliation":[{"name":"MRC Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College London, London WC1V 6LJ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6683-5164","authenticated-orcid":false,"given":"Miguel Angel","family":"Luque Fernandez","sequence":"additional","affiliation":[{"name":"Inequalities in Cancer Outcomes Network, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK"},{"name":"Noncommunicable Disease and Cancer Epidemiology Group, Instituto de Investigaci\u00f3n Biosanitaria de Granada, Ibs.GRANADA, Andalusian School of Public Health, 18012 Granada, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Epidemiolog\u00eda y Salud P\u00fablica (CIBER of Epidemiology and Public Health, CIBERESP), 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey","family":"Bonaventure","sequence":"additional","affiliation":[{"name":"Epidemiology of Childhood and Adolescent Cancers Team, Research Centre in Epidemiology and Biostatistics (CRESS), Inserm UMR 1153, Universit\u00e9 de Paris, 94801 Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Gachau","sequence":"additional","affiliation":[{"name":"School of Mathematics, University of Nairobi, Nairobi 30197-00100, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Benitez Majano","sequence":"additional","affiliation":[{"name":"Inequalities in Cancer Outcomes Network, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5837-7773","authenticated-orcid":false,"given":"Bernard","family":"Rachet","sequence":"additional","affiliation":[{"name":"Inequalities in Cancer Outcomes Network, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edmund Njeru","family":"Njagi","sequence":"additional","affiliation":[{"name":"Inequalities in Cancer Outcomes Network, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1038\/bjc.2016.304","article-title":"Cancer Incidence and Mortality Projections in the UK until 2035","volume":"115","author":"Smittenaar","year":"2016","journal-title":"Br. 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