Jihyun Kwon1, So Young Kim2,3,4, Kyoung Eun Yeob3, Hye Sook Han1,5, Ki Hyeong Lee1,5, Dong Wook Shin6,7, Yeon-Yong Kim8, Jong Heon Park8, Jong Hyock Park3,4. 1. Division of Hematology-Oncology, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea. 2. Department of Public Health and Preventive Medicine, Chungbuk National University Hospital, Cheongju, Korea. 3. 3Graduate School of Health Science Business Convergence, Chungbuk National University College of Medicine, Cheongju, Korea. 4. T. H. Chan School of Public Health, Harvard University, Boston, MA, USA. 5. Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea. 6. Supportive Care Center/Department of Family Medicine, Samsung Medical Center, Seoul, Korea. 7. Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Korea. 8. Big Data Steering Department, National Health Insurance Service, Wonju, Korea.
Abstract
Purpose: This study aimed to determine whether the diagnosis, treatment approach and prognosis of multiple myeloma (MM) vary according to the presence and type of disability. Materials and Methods: Demographic, socioeconomic, and medical data were obtained from the National Disability Database, the Korean Central Cancer Registry, and the Korean National Health Insurance claims database. An age- and sex-matched cohort was established using a 1:3 ratio constituted with 2,776,450 people with disabilities and 8,329,350 people without disabilities. Adult patients diagnosed with MM were subsequently selected from this cohort. Disabilities were categorized as physical, communication, intellectual or psychological, and affecting the major internal organs. Results: The cohort included 4,090 patients with MM, with a significantly lower rate per 100,000 persons among people with disabilities than among people without disabilities (29.1 vs. 39.4, p<0.001). People with disabilities were more likely to undergo dialysis treatment at the time of diagnosis (16.3% vs. 10.0%, p<0.001), but were less likely to undergo autologous stem cell transplantation (37.5% vs. 43.7%, p=0.072). This trend was more evident among patients with intellectual or psychological disabilities. The median overall survival among patients with disabilities was significantly shorter than that among patients without disabilities (36.8 months vs 51.2 months, p<0.001). Conclusion: In Korea, people with disabilities generally have a lower rate of MM diagnosis, receive less intensive treatment, and have a lower survival rate than people without disabilities.
Purpose: This study aimed to determine whether the diagnosis, treatment approach and prognosis of multiple myeloma (MM) vary according to the presence and type of disability. Materials and Methods: Demographic, socioeconomic, and medical data were obtained from the National Disability Database, the Korean Central Cancer Registry, and the Korean National Health Insurance claims database. An age- and sex-matched cohort was established using a 1:3 ratio constituted with 2,776,450 people with disabilities and 8,329,350 people without disabilities. Adult patients diagnosed with MM were subsequently selected from this cohort. Disabilities were categorized as physical, communication, intellectual or psychological, and affecting the major internal organs. Results: The cohort included 4,090 patients with MM, with a significantly lower rate per 100,000 persons among people with disabilities than among people without disabilities (29.1 vs. 39.4, p<0.001). People with disabilities were more likely to undergo dialysis treatment at the time of diagnosis (16.3% vs. 10.0%, p<0.001), but were less likely to undergo autologous stem cell transplantation (37.5% vs. 43.7%, p=0.072). This trend was more evident among patients with intellectual or psychological disabilities. The median overall survival among patients with disabilities was significantly shorter than that among patients without disabilities (36.8 months vs 51.2 months, p<0.001). Conclusion: In Korea, people with disabilities generally have a lower rate of MM diagnosis, receive less intensive treatment, and have a lower survival rate than people without disabilities.
Authors: Jin Young Choi; Kyoung Eun Yeob; Seung Hwa Hong; So Young Kim; Eun-Hwan Jeong; Dong Wook Shin; Jong Heon Park; Gil-Won Kang; Hak Soon Kim; Jong Hyock Park; Ichiro Kawachi Journal: Cancer Control Date: 2021 Jan-Dec Impact factor: 3.302