Impact of Demography, Ethnicity, Co-morbidities and Inequalities on Outcomes in High-Grade Lymphoma Across the UKCHART Network (DECIPHER)

Despite the provision of universal healthcare through the National Health Service (NHS), variation in treatment delivery and outcomes among patients with diffuse large B-cell lymphoma (DLBCL) persists. Previous UK population-based studies have demonstrated that socioeconomic factors and multimorbidity influence survival outcomes in aggressive lymphoma, with patients from more deprived backgrounds experiencing poorer outcomes than those from less deprived areas.

Furthermore, multimorbidity has been associated with diagnostic delay and emergency presentation, factors known to adversely affect lymphoma outcomes.

National datasets such as the National Cancer Registration and Analysis Service (NCRAS) and the Systemic Anti-Cancer Therapy (SACT) database provide valuable population-level real-world evidence and have improved understanding of lymphoma outcomes at a national level. However, these datasets often lack the detailed clinical information required to fully explore the impact of ethnicity, socioeconomic deprivation, frailty, comorbidity burden, treatment modifications, and treatment delivery on patient outcomes.

The UK Consortium for Haematology Audit, Real-world Data and Trials (UKCHART) provides a unique opportunity to address these evidence gaps. Through a network of participating NHS organisations serving a large, diverse, and geographically distributed population, UKCHART enables the collection of detailed patient-level clinical data that are not routinely available within national registries. The demographic diversity of the UKCHART population makes it particularly well suited to investigating healthcare inequalities and understanding how ethnicity, deprivation, and comorbidity influence treatment delivery and outcomes in patients with DLBCL.

This study will utilise the UKCHART network to evaluate the impact of ethnicity, socioeconomic deprivation, and comorbidity burden on the delivery of frontline chemoimmunotherapy and subsequent clinical outcomes in patients with newly diagnosed DLBCL. By generating contemporary UK real-world evidence, the study aims to identify potentially modifiable factors contributing to outcome disparities and inform future strategies to improve equity of care for patients with high-grade lymphoma.