A recent study by Drury McAlarney, Albert Einstein College of Medicine, Bronx, NY, and colleagues examined how demographic factors of patients with diffuse large B-cell lymphoma (DLBCL) impact their time to diagnosis. A summary of their findings was published in conjunction with the 2023 ASCO Annual Meeting.

Because patients with DLBCL can be asymptomatic until more severe and/or terminal symptoms occur—such as end-organ complications or tumor lysis syndrome—there is often a delayed diagnosis. McAlarney and colleagues used data from the Montefiore Health System to conduct a retrospective cohort study to investigate the factors contributing to this delay. The study’s cohort consisted of 1,076 patients with DLBCL; of these patients, 24.7% were non-Hispanic White, 26.5% were non-Hispanic Black, 7.25% were Hispanic, and 41.5% identified as “other” race or ethnicity. 

The researchers used logistic regression models, which were stratified by insurance status, to investigate the impact of a patient’s socioeconomic status, race, and primary language spoken at home on the time to diagnosis. They also calculated odds ratios (ORs) for increased time to diagnosis based on the primary language of patients who had a higher than median time to diagnosis.

The study found that the average time from when the patients first experienced symptoms to DLBCL diagnosis was 115.76 days. Non-Hispanic White patients had the highest time until diagnosis at 188.4 days, while Hispanic participants had the lowest time until diagnosis at 85.8 days (P = .03). In addition, the average age at which patients were diagnosed was different depending on their race and/or ethnicity. Non-Hispanic White patients received diagnosis at an average age of 67.4 years, while non-Hispanic Black patients were diagnosed at an average age of 57.3 years (P < .0001). Another important finding was that non-English speaking patients with DLBCL had a higher OR for increased time to diagnosis, with the OR being significantly higher for those who identified their preferred language as one other than English or Spanish (for Spanish as preferred language: adjusted OR = 1.99; 95% confidence interval [CI], 0.97-4.06; P = .059. “Other” as preferred language: adjusted OR = 3.15; 95% CI, 1.01-9.75; P = .047).

“Differences by racial or ethnic group supported the finding that primary Spanish speakers experience increased times until diagnosis—Hispanic participants had a lower average time to diagnosis than other racial or ethnic groups, suggesting that the effect of language alone may be greater than this analysis suggested when race and ethnicity is controlled for,” said McAlarney and colleagues.

The researchers suggested that increasing resources for non-English speaking patients with DLBCL, including providing them with literature on preventative screening in non-English languages and having more health care workers with knowledge of common foreign languages, may improve morbidity outcomes for these patients.

Source:

McAlarney D, Davit M, Hosgood D, Shastri A. Demographic factors impacting time to diagnosis of diffuse large B-cell lymphoma. Presented at: the 2023 ASCO Annual Meeting; June 2-6, 2023; Chicago, IL, and virtual; Abstract e18660.