Self-reported health and survival in older patients diagnosed with multiple myeloma

Cancer Causes Control. 2020 Jul;31(7):641-650. doi: 10.1007/s10552-020-01305-0. Epub 2020 Apr 30.

Abstract

Purpose: Patient-reported outcomes such as self-reported health (SRH) are important in understanding quality cancer care, yet little is known about links between SRH and outcomes in older patients with multiple myeloma (MM). We evaluated associations between SRH and mortality among older patients with MM.

Methods: We analyzed a retrospective cohort of patients ages ≥ 65 years diagnosed with first primary MM using the Surveillance, Epidemiology, and End Results (SEER)-Medicare Health Outcomes Survey (MHOS) data resource. Pre-diagnosis SRH was grouped as high (excellent/very good/good) or low (fair/poor). We used Cox proportional hazards models to estimate adjusted hazard ratios (HR) and 95% confidence intervals (CI) for associations between SRH and all-cause and MM-specific mortality.

Results: Of 521 MM patients with mean (SD) age at diagnosis of 76.8 (6.1) years, 32% reported low SRH. In multivariable analyses, low SRH was suggestive of modest increased risks of all-cause mortality (HR 1.32, 95% CI 1.02-1.71) and MM-specific mortality (HR 1.22, 95% CI 0.87-1.70) compared to high SRH.

Conclusion: Findings suggest that low pre-diagnosis SRH is highly prevalent among older patients with MM and is associated with modestly increased all-cause mortality. Additional research is needed to address quality of life and modifiable factors that may accompany poor SRH in older patients with MM.

Keywords: Cancer-specific mortality; Multiple myeloma; Self-reported health; Survival.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Female
  • Health Status*
  • Humans
  • Male
  • Medicare / statistics & numerical data
  • Multiple Myeloma / diagnosis*
  • Multiple Myeloma / mortality*
  • Proportional Hazards Models
  • Quality of Life
  • Retrospective Studies
  • SEER Program
  • Self Report / statistics & numerical data*
  • Surveys and Questionnaires
  • United States / epidemiology