Buechler CR, Sagher E, and Tisack A. 32388 Demographic and socioeconomic factors drive disparate outcomes in mycosis fungoides. J Am Acad Dermatol 2022; 87(3):AB38.
J Am Acad Dermatol
Background: Mycosis fungoides (MF) occurs more frequently in young Black patients, though debate persists as to whether this group is at uniformly increased risk of poorer outcomes. Recent studies have postulated that outcomes among Black patients are heterogeneous, though previous literature suggests that demographics may play a role in MF.
Methods: Clinicopathologic, sociodemographic, and follow-up data were analyzed for patients with MF at Henry Ford Health Systems in Detroit, MI, over 19 years. Data were analyzed for factors predicting progression-free survival (PFS) via multivariable stepwise Cox proportional hazards regression models and Kaplan-Meier analysis of intersectional demographic groups based on age at diagnosis (<40 or ≥40), race, and sex.
Results: Of the 440 patients, a majority (52.7%) were male, and the most common race/ethnicity was White/Caucasian (50.2%), followed by Black/African American (40%). Medicaid insurance was an independent predictor of shortened PFS (HR 3.13, 95% CI 1.46-6.69) regardless of race, and young Black patients had the shortest PFS, with young Black female patients experiencing shorter PFS than their older Black female (P =.027) and younger Black male (P =.014) counterparts.
Conclusions: This study provides the strongest evidence to date that demographic and socioeconomic factors should be a part of the prognostic picture in MF. Their predictive value is likely based on societal and additional health-related variables, such as access to care/medication, health literacy, and bias in a provider or health system. It is our hope that this analysis will spur continued discussion as to the cause and effect of such differences in MF outcomes.