Abstract C096: Association of the social vulnerability index with chronic lymphocytic leukemia incidence and survival rates in metropolitan Detroit

Abstract Background/Objective: The Social Vulnerability Index (SVI), a census-tract-based index based on socioeconomic status, race and ethnicity, household characteristics, and accessibility of transportation, identifies communities that may be more vulnerable to health issues and thus need additional support. Studies have used the SVI to explore the survival rate and mortality rate of many common cancers, but not yet chronic lymphocytic leukemia (CLL). This study aimed to assess the relationship between CLL survival rates, hazard of death rates, and economic vulnerability levels as defined by the SVI in the Detroit metropolitan area. Methods: This was a retrospective, population-based study among people diagnosed with CLL from 2016 to 2020 residing in the Detroit tri-county area (Wayne County, Macomb County, and Oakland County) as recorded in the Metropolitan Detroit Cancer Surveillance System. Participants’ SVI scores, based on address at diagnosis, were categorized into quartiles. The lowest quartile (Q1) represented the lowest social vulnerability and a greater capacity to withstand the effects of public health issues and chronic disease. The highest quartile (Q4) represented the highest social vulnerability and was thus less likely to withstand the effects of public health issues and chronic disease. Proportional hazard regression was used to estimate the hazard of death for each quartile. Results: A total of 1406 CLL patients living in the Detroit tri-county metropolitan area were included. Within Q4, notable variables were minority status (65.1%), sub-150% poverty level (43.4%), and living in “housing cost-burdened occupied housing units with an annual income lower than $75,000” or also known as Section 8 Housing (39.9%). Overall SVI score as well as all individual SVI subthemes followed a trend of increased hazard of death rate and decreased five-year survival rate when seen with increased SVI quartile. Overall SVI score and all subthemes except Racial & Ethnic Minority Status had statistically significant results. Q1 had the highest 5-year survival rate (76.7%) and was nearly 20% higher than the 5-year survival rate seen in Q4 (56.9%). Those residing in areas with a Q4 SVI score were 2.02 times more likely to die from CLL compared to those residing in areas with a Q1 SVI score. Conclusions: This study’s findings provide a foundation for the implementation of programs and policy changes to address socioeconomic burdens that negatively contribute to the survival rate and death rate disparities among CLL patients. The results from our study also provide a framework for future studies to explore the influence of social determinants of health on survival rates and outcomes for people diagnosed with CLL in similar urban areas across the country. Citation Format: Diana Duque, E. Fernanda. Tapia, Julie Ruterbusch, Felicity Harper. Association of the social vulnerability index with chronic lymphocytic leukemia incidence and survival rates in metropolitan Detroit [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr C096.