In an analysis of the EUROCARE-6 data set reported in The Lancet Oncology, Milena Sant, MD, and colleagues found that patients with lymphoid neoplasms from European countries with greater health expenditure had improved 10-year age-standardized relative survival.
Milena Sant, MD
Study Details
The study involved data from 890,730 lymphoid malignancy cases of 12 different types that were diagnosed from 2001 to 2013 at 81 registries in 27 European countries. Countries were classified according to mean total national health expenditure quartiles in 2001 to 2013. A primary outcome measure was 10-year age-standardized relative survival across countries, which was analyzed according to national health expenditure quartile.
Key Findings
Median follow-up was 13 years. Among the 12 lymphoid malignancies, 10-year age-standardized relative survival in Europe was highest for hairy cell leukemia (82.6%) and Hodgkin lymphoma (79.3%) and lowest for plasma cell neoplasms (29.5%).
Relative excess risk of death increased with age at diagnosis for all lymphoid malignancies. Women had higher 10-year age-standardized relative survival vs men for all lymphoid malignancies, except precursor B-, T-, or NK-cell or not–otherwise-specified lymphoblastic lymphoma or leukemia.
The 10-year age-standardized relative survival for each lymphoid malignancy was higher and the relative excess risk of death was lower in countries in the highest health expenditure quartile vs those in the lowest quartile. For example, for non-Hodgkin lymphoma—considered the most representative of the malignancies based on number of cases—10-year age-standardized relative survival for the first, second, third, and fourth quartiles was 59.3%, 57.6%, 55.4%, and 44.7%, respectively; compared with the European mean, the relative excess risk of death values from highest to lowest expenditure quartiles were 0.80, 0.91, 0.94, and 1.45.
The investigators concluded, “Total national health expenditure is associated with geographical inequalities in lymphoid malignancy prognosis. Policy decisions on allocating economic resources and implementing evidence-based models of care are needed to reduce these differences.”
Claudia Vener, MD, of the Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, is the corresponding author for The Lancet Oncology article.
Disclosure: The study was funded by the Italian Ministry of Health, European Commission, and Estonian Research Council. For full disclosures of the study authors, visit thelancet.com.
