P196 United Kingdom, divided outcomes? Exploring race/ethnicity differences in cutaneous T-cell lymphoma using PROCLIPI

Abstract

Several studies, primarily from US centres, have identified racial disparities in cutaneous T-cell lymphoma (CTCL) incidence, treatment access and disease outcomes. A recent population-based study analysing skin cancer incidence by ethnicity found a higher incidence of CTCL in Other and Black ethnic groups in the UK. This study presents emerging evidence utilizing data from the PROspective Cutaneous Lymphoma International Prognostic Index (PROCLIPI) study UK cohort. A retrospective analysis was conducted of all patients (n = 583) from expert centres from across the UK (n = 12), including health-related quality of life (HRQoL). Categorization of ethnicity was matched to UK census data. There was a higher incidence of CTCL in White (+0.7%) and Black (+1.9%) patients in comparison with the UK general population. Diagnosis at an early stage (IA–IIA) was comparable across all groups. However, Asian and Black patients had a lower median age at diagnosis (45 and 52 years, respectively) than White patients (65 years). This was despite patients who were not White having a longer median time to diagnosis (36 months) than White patients (60 months). Black patients showed the shortest median time to disease progression (24 months) of all of the groups. All-cause mortality was higher in White patients (27%) than in all of the other groups (17%). Patients who were not White reported significantly worse HRQoL than White patients (P < 0.001). UK PROCLIPI data demonstrate ethnic differences in the epidemiology, clinical course and patient-reported outcomes of CTCL. Incidence rates are broadly proportional to those in the UK population, with a similar distribution of stage at diagnosis across groups. However, patients who are not White were diagnosed at a younger age, experienced longer diagnostic delays, and reported significantly poorer HRQoL at presentation. Importantly, these disparities were observed in the context of the NHS, highlighting that equality of access does not necessarily translate to equity of outcomes. This study heightens the need to identify the underlying drivers of these disparities.