Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-04T18:26:00.345Z Has data issue: false hasContentIssue false

Socioeconomic Status and Chemotherapy Use for Melanoma in Older People*

Published online by Cambridge University Press:  01 March 2011

Carlos A. Reyes-Ortiz*
Affiliation:
University of North Texas Health Science Center
James S. Goodwin
Affiliation:
University of Texas Medical Branch
Dong D. Zhang
Affiliation:
University of Texas Medical Branch
Jean L. Freeman
Affiliation:
University of Texas Medical Branch
*
Correspondence and requests for offprints should be sent to / La correspondance et les demandes de tirés-à-part doivent être adressées à: Carlos A. Reyes-Ortiz, M.D., Ph.D. Department of Social & Behavioral Sciences School of Public Health University of North Texas Health Science Center 3500 Camp Bowie Boulevard (EAD-711B) Fort Worth, TX 76107-2699 ([email protected])

Abstract

The study objective was to examine the association, among older persons with cutaneous melanoma, between areal socioeconomic status (SES) and receiving chemotherapy. SEER-Medicare-linked database (1,239 white men and women aged ≥ 66, with invasive melanoma [regional and distant stages]; 1991–1999) was used. SES was measured by census tract poverty level (average of 1990 and 2000 Census data). Covariates were sociodemographics, tumor characteristics, and comorbidity index. Residing in poorer SES areas was associated with a lower likelihood for receiving chemotherapy among patients in the overall sample (adjusted odds ratios = OR 0.97, 95% confidence interval = CI 0.95–0.99), and those with regional stage at diagnosis (OR 0.97, 95% CI 0.94–0.98). These findings reflect socioeconomic disparities in chemotherapy use for melanoma among older white patients in the United States.

Résumé

L’objectif de cette étude était d’examiner l’association entre la zone de statut socio-économique (SSE) et recevant une chimiothérapie chez les personnes âgées atteints de mélanome cutané. Une base de données liée à SEER-Medicare (1.329 hommes et femmes blancs âgés de ≥ 66, avec des étapes de mélanome invasif [régionaux et éloignés]; 1991-1999) a été utilisé. SSE a été mesurée par le niveau de pauvreté des secteurs de recensement (moyenne de 1990 et 2000 des données du recensement). Covariables ont été données sociodémographiques, caractéristiques de la tumeur et l’indice de comorbidité. Résidant dans les régions les plus pauvres SES a été associée à une faible probabilité de recevoir une chimiothérapie chez les patients de l’échantillon global (odds ratios ajustés = ou 0,97, intervalle de confiance IC 95% = 0.95 à 0.99), et ceux au stade régional au moment du diagnostic (OR 0,97, IC à 95% de 0.94 à 0.98). Ces résultats reflètent les disparités socio-économiques dans l’utilisation de chimiothérapie pour le mélanome chez les patients âgés blancs aux Etats-Unis.

Type
Regular Articles / Articles réguliers
Copyright
Copyright © Canadian Association on Gerontology 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

This work was supported by the Agency of Healthcare Research and Quality (R24 HS011618-04) and by the National Cancer Institute (University of Texas Medical Branch, Center on Population Health and Health Disparities – P50CA105631).

References

American Medical Association. (1993). Physicians’ current procedural terminology: CPT 94. Chicago, IL: American Medical Association.Google Scholar
Atzpodien, J., Neuber, K., Kamanabrou, D., Fluck, M., Bröcker, E.B., Neumann, C., et al. . (2002). Combination chemotherapy with or without s.c. IL-2 and IFN-alpha: Results of a prospectively randomized trial of the Cooperative Advanced Malignant Melanoma Chemo immunotherapy Group (ACIMM). British Journal of Cancer, 86(2), 179184.CrossRefGoogle ScholarPubMed
Bach, P.B., Guadagnoli, E., Schrag, D., Schussler, N., & Warren, J.L. (2002). Patient demographic and socioeconomic characteristics in the SEER-Medicare database. Medical Care, 40(Suppl. 8), IV19IV25.CrossRefGoogle ScholarPubMed
Barzilai, D.A., Koroukian, S.M., Neuhauser, D., Cooper, K.D., Rimm, A.A., & Cooper, G.S. (2004). The sensitivity of Medicare data for identifying incident cases of invasive melanoma (United States). Cancer Causes & Control, 15(2), 179184.CrossRefGoogle ScholarPubMed
Blustein, J. (1995). Medicare coverage, supplemental insurance, and the use of mammography by older women. The New England Journal of Medicine, 332(17), 11381143.CrossRefGoogle ScholarPubMed
Charlson, M.E., Pompei, P., Ales, K.L., & MacKenzie, C.R. (1987). A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. Journal of Chronic Diseases, 40(5), 373383.CrossRefGoogle ScholarPubMed
Chiarion-Sileni, V., Del Bianco, P., De Salvo, G.L., Lo Re, G., Romanini, A., Labianca, R., et al. . (2003). Quality of life evaluation in a randomised trial of chemotherapy versus bio-chemotherapy in advanced melanoma patients. European Journal of Cancer, 39(11), 15771585.CrossRefGoogle Scholar
Cocconi, G., Passalacqua, R., Foladore, S., Carlini, P., Acito, L., Maiello, E., et al. . (2003). Treatment of metastatic malignant melanoma with dacarbazine plus tamoxifen, or vindesine plus tamoxifen: A prospective randomized study. Melanoma Research, 13(1), 7379.CrossRefGoogle ScholarPubMed
Diez Roux, A.V., & Mair, C. (2010). Neighborhoods and health. Annals of the New York Academy of Sciences, 1186, 125145.CrossRefGoogle ScholarPubMed
Di Lauro, V., Scalone, S., La Mura, N., Zanetti, M., Nigri, P., Freschi, A., et al. . (2005). Combined chemoimmunotherapy of metastatic melanoma: A single institution experience. Melanoma Research, 15(3), 209212.CrossRefGoogle ScholarPubMed
Du, X.L., & Goodwin, J.S. (2001a). Increase of chemotherapy use in older women with breast carcinoma from 1991 to 1996. Cancer, 92(4), 730737.3.0.CO;2-P>CrossRefGoogle ScholarPubMed
Du, X.L., & Goodwin, J.S. (2001b). Patterns of use of chemotherapy for breast cancer in older women: Findings from Medicare claims data. Journal of Clinical Oncology, 19(5), 14551461.CrossRefGoogle ScholarPubMed
Earle, C.C., Neumann, P.J., Gelber, R.D., Weinstein, M.C., & Weeks, J.C. (2002). Impact of referral patterns on the use of chemotherapy for lung cancer. Journal of Clinical Oncology, 20(7), 17861792.CrossRefGoogle ScholarPubMed
Eigentler, T.K., Caroli, U.M., Radny, P., & Garbe, C. (2003). Palliative therapy of disseminated malignant melanoma: A systematic review of 41 randomized clinical trials. The Lancet Oncology, 4(12), 748759.CrossRefGoogle Scholar
Eton, O., Legha, S.S., Bedikian, A.Y., Lee, J.J., Buzaid, A.C., Hodges, C., et al. . (2002). Sequential biochemotherapy versus chemotherapy for metastatic melanoma: Results from a phase III randomized trial. Journal of Clinical Oncology, 20(8), 20452052.CrossRefGoogle ScholarPubMed
Falkson, C.I., Ibrahim, J., Kirkwood, J.M., Coates, A.S., Atkins, M.B., & Blum, R.H. (1998). Phase III trial of dacarbazine versus dacarbazine with interferon α-2b versus dacarbazine with tamoxifen versus dacarbazine with interferon α-2b and tamoxifen in patients with metastatic malignant melanoma: An Eastern Cooperative Oncology Group study. Journal of Clinical Oncology, 16(5), 17431751.CrossRefGoogle ScholarPubMed
Freeman, J.L., Klabunde, C.N., Schussler, N., Warren, J.L., Virnig, B.A., & Cooper, G.S. (2002). Measuring breast, colorectal, and prostate cancer screening with Medicare claims data. Medical Care, 40(Suppl. 8), IV-36-42.CrossRefGoogle ScholarPubMed
Gorey, K.M., Holowaty, E.J., Fehringer, G., Laukkanen, E., Richter, N.L., & Meyer, C.M. (2000). An international comparison of cancer survival: Metropolitan Toronto, Ontario and Honolulu, Hawaii. American Journal of Public Health, 90, 18661872.Google ScholarPubMed
Gorey, K.M., Luginaah, I.N., Bartfay, E., Fung, K.Y., Holowaty, E.J., Wright, F.C., et al. . (2011). Effects of socioeconomic status on colon cancer treatment accessibility and survival in Toronto, Ontario, and San Francisco, California, 1996-2006. American Journal of Public Health. 101(1), 112119.CrossRefGoogle ScholarPubMed
Gross, C.P., Filardo, G., Mayne, S.T., & Krumholz, H.M. (2005). The impact of socioeconomic status and race on trial participation for older women with breast cancer. Cancer, 103(3), 483491.CrossRefGoogle ScholarPubMed
Health Care Financing Administration. (1994). HCFA common procedure coding system (HCPCS): National level II Medicare codes. Los Angeles, CA: Practice Management Information Corporation.Google Scholar
Health Care Financing Administration. (1999). HCFA common procedure coding system (HCPCS): National level II Medicare codes. Los Angeles, CA: Practice Management Information Corporation.Google Scholar
Health Care Financing Administration. (2000). Data user reference guide (DURG). Baltimore, MD: Health Care Financing Administration.Google Scholar
Jungnelius, U., Ringborg, U., Aamdal, S., Mattsson, J., Stierner, U., Ingvar, C., et al. . (1998). Dacarbazine-vindesine versus dacarbazine-vindesine-cisplatin in disseminated malignant melanoma. A randomised phase III trial. European Journal of Cancer, 34(9), 13681374.CrossRefGoogle ScholarPubMed
Koedoot, C.G., de Haan, R.J., Stiggelbout, A.M., Stalmeier, P.F., de Graeff, A., Bakker, P.J., et al. . (2003). Palliative chemotherapy or best supportive care? A prospective study explaining patients’ treatment preference and choice. British Journal of Cancer, 89(12), 22192226.CrossRefGoogle ScholarPubMed
Krieger, N. (1992). Overcoming the absence of socioeconomic data in medical records: Validation and application of a census-based methodology. American Journal of Public Health, 92, 703710.CrossRefGoogle Scholar
Krieger, N., Chen, J.T., Waterman, P.D., Rehkopf, D.H., & Subramanian, S.V. (2003). Race/ethnicity, gender, and monitoring socioeconomic gradients in health: A comparison of area-based socioeconomic measures – The public health disparities geocoding project. American Journal of Public Health, 93(10), 16551671.CrossRefGoogle Scholar
Lamont, E.B., Herndon, J.E. II, Weeks, J.C., Henderson, I.C., Lifenbaum, R., Schilsky, R.L., et al. . (2005). Criterion validity of Medicare chemotherapy claims in Cancer and Leukemia Group B breast and lung cancer trial participants. Journal of the National Cancer Institute, 97(14), 10801083.CrossRefGoogle Scholar
Luo, R., Giordano, S.H., Freeman, J.L., Zhang, D., & Goodwin, J.S. (2006). Referral to medical oncology: A crucial step in the treatment of older patients with stage III colon cancer. Oncologist, 11(9), 10251033.CrossRefGoogle ScholarPubMed
National Cancer Institute. (1994). The SEER program code manual (revised ed.). Bethesda, MD: National Cancer Institute. NIH Publication No.94–1999.Google Scholar
National Cancer Institute and the Centers for Medicare and Medicaid Services (CMS) (2007). SEER-Medicare: Brief Description of the SEER-Medicare Database. Retrieved September 02, 2007, fromhttp://healthservices.cancer.gov/seermedicare/overview/brief.htmlGoogle Scholar
Ostbye, T., Greenberg, G.N., Taylor, D.H., & Lee, A.M.M. (2003). Screening mammography and Pap tests among older American women 1996-2000: Results from the Health and Retirement Study (HRS) and Asset and Health Dynamics among the oldest old (AHEAD). Annals of Family Medicine, 1(4), 209217.CrossRefGoogle ScholarPubMed
Penchansky, R., & Thomas, J.W. (1981). The concept of access: Definition and relationship to consumer satisfaction. Medical Care, 19, 127140.CrossRefGoogle ScholarPubMed
Polednak, A.P. (2004). Chemotherapy of non-elderly breast cancer patients by poverty-rate of area of residence in Connecticut. Breast Cancer Research and Treatment, 83(3), 245248.CrossRefGoogle Scholar
Potosky, A.L., Riley, G.F., Lubitz, J.D., Mentnech, R.M., & Kessler, L.G. (1993). Potential for cancer related health services research using a linked Medicare-tumor registry database. Medical Care, 31(8), 732748.CrossRefGoogle ScholarPubMed
Reyes-Ortiz, C.A., Goodwin, J.S., Freeman, J.L., & Kuo, Y.-F. (2006). Socioeconomic status and survival in older patients with melanoma. Journal of the American Geriatrics Society, 54(11), 17581764.CrossRefGoogle ScholarPubMed
Reyes-Ortiz, C.A., & Markides, K.S. (2010). Socioeconomic factors, immigration status, and cancer screening among Mexican American women aged 75 and older. Health Care for Women International, 31(12), 10681081.CrossRefGoogle Scholar
Richards, M.A., Ramirez, A.J., Degner, L.F., Fallowfield, L.J., Maher, E.J., & Neuberger, J. (1995). Offering choice of treatment to patients with cancers. European Journal of Cancer, 31A(1), 112116.CrossRefGoogle ScholarPubMed
Ridolfi, R., Chiarion-Sileni, V., Guida, M., Romanini, A., Labianca, R., Freschi, A., et al. . (2002). Cisplatin, dacarbazine with or without subcutaneous interleukin-2, and interferon alpha-2b in advanced melanoma outpatients: Results from an Italian multicenter phase III randomized clinical trial. Journal of Clinical Oncology, 20(6), 16001607.CrossRefGoogle ScholarPubMed
Ries, L.A.G., Eisner, M.P., Kosary, C.L., Hankey, B.F., Miller, B.A., Clegg, L., et al. . (Eds.). (2005). SEER cancer statistics review, 1975-2002. Bethesda, MD: National Cancer Institute. Retrieved 2006 November, fromhttp://seer.cancer.gov/csr/1975_2002/. Based on November 2004 SEER data submission, posted to the SEER web site 2005.Google Scholar
Romano, P.S., Roos, L.L., & Jollis, J.G. (1993). Adapting a clinical comorbidity index for use with ICD-9-CM administrative data: Differing perspectives. Journal of Clinical Epidemiology, 46(10), 10751079.CrossRefGoogle ScholarPubMed
Sateren, W.B., Trimble, E.L., Abrams, J., Brawley, O., Breen, N., Ford, L., et al. . (2002). How sociodemographics, presence of oncology specialists and hospital cancer programs affect accrual to cancer treatment trials. Journal of Clinical Oncology, 20(8), 21092117.CrossRefGoogle ScholarPubMed
Schrag, D., Rifas-Shiman, S., Saltz, L., Bach, P.B., & Begg, C.B. (2002). Adjuvant chemotherapy use for Medicare beneficiaries with stage II colon cancer. Journal of Clinical Oncology, 20(19), 39994005.CrossRefGoogle ScholarPubMed
Shah, G.D., & Chapman, P.B. (2007). Adjuvant therapy of melanoma. Cancer Journal, 13(3), 217222.CrossRefGoogle ScholarPubMed
Stein, J.A., & Brownell, I. (2008). Treatment approaches for advanced cutaneous melanoma. Journal of Drugs in Dermatology, 7(2), 175179.Google ScholarPubMed
Thirlwell, C., & Nathan, P. (2008). Melanoma part 2: Management. BMJ, 337, a2488.CrossRefGoogle ScholarPubMed
US Public Health Services. (1996). International classification of diseases, 9th revision. Clinical modification (5th ed.). Los Angeles, CA: Practice Management Information Corporation.Google Scholar
Verma, S., Quirt, I., McCready, D., Bak, K., Charette, M., & Iscoe, N. (2006). Systematic review of systemic adjuvant therapy for patients at high risk for recurrent melanoma. Cancer, 106(7), 14311442.CrossRefGoogle ScholarPubMed
Warren, J.L., Klabunde, C.N., Schrag, D., Bach, P.B., & Riley, G.F. (2002). Overview of the SEER-Medicare data: Content, research applications, and generalizability to the United States elderly population. Medical Care, 40(Suppl. 8), IV-3-18.CrossRefGoogle Scholar
Zell, J.A., Cinar, P., Mobasher, M., Ziogas, A., Meyskens, F.L. Jr., & Anton-Culver, H. (2008). Survival for patients with invasive cutaneous melanoma among ethnic groups: The effects of socioeconomic status and treatment. Journal of Clinical Oncology, 26(1), 6675.CrossRefGoogle Scholar