Objectives: Acute myeloid leukaemia (AML) is a disease of older adults, who are vulnerable to socioeconomic factors. We determined AML incidence in older adults and the impact of socioeconomic factors on outcomes.
Methods: We included 3024 AML patients (1996-2016) identified from a population-based registry.
Results: AML incidence in patients ≥60 years increased from 11.01 (2001-2005) to 12.76 (2011-2016) per 100,000 population. Amongst 879 patients ≥60 years in recent eras (2010-2016), rural residents (<100,000 population) were less likely to be assessed by a leukaemia specialist (39% rural, 47% urban, p=0.032); no difference was seen for lower (43%, quintile 1-3) versus higher (47%, quintile 4-5) incomes (p=0.235). Similar numbers received induction chemotherapy between residence (16% rural, 18% urban, p=0.578) and incomes (17% lower, 17% high, p=1.0). Differences between incomes were seen for hypomethylating agent treatment (14% low, 20% high, p=0.041); this was not seen for residence (13% rural, 18% urban, p=0.092). Amongst non-adverse karyotype patients ≥70 years, 2-year overall survival was worse for rural (5% rural, 12% urban, p=0.006) and lower income (6% low, 15% high, p=0.017) patients.
Conclusions: AML incidence in older adults is increasing, and outcomes are worse for older rural and low-income residents; these patients face treatment barriers.