Takeaway
- No association between socioeconomic deprivation and incidence of acute lymphoblastic leukaemia (ALL).
- Significant association between survival and socioeconomic deprivation.
- Low-volume hospitals had higher rates of mortality.
Why this matters
- The association between survival and case volume has significant implications for the organisation of services for adults with ALL.
Key results
- Crude annual incidence of ALL in the 12-year study period was 0.61/100,000 population.
- 5-year survival was 32%.
- No evidence of an association between socioeconomic deprivation and incidence.
- Compared with patients living in the least deprived areas, mortality rates were higher for patients living in intermediate and most deprived areas (HR, 21%; 95% CI, 8%-35%, and HR, 16%; 95% CI, 3%-30%, respectively).
- Mortality was 33% higher in low-volume vs high-volume hospitals (HR, 33%; 95% CI, 3%-73%).
- Incidence was higher in men, but there was no evidence of a sex difference in survival.
- Rurality was not associated with incidence or survival.
Study design
- Data from the NHS admissions data for England up to March 2013 and census area of residence.
- Hospital volume was assessed in a 3-year subset of data with consistent hospital provider codes.
- Funding: Amgen Ltd.
Limitations
- Potential for coding and data entry errors.
- Volume indicator based on a relatively small number of cases.
References
References