Epidemiologic Trends of Cutaneous T-Cell Lymphoma in Arkansas Reveals Demographic Disparities

SIMPLE SUMMARY: Cutaneous T-cell lymphomas (CTCLs) are rare non-Hodgkin’s lymphomas characterized by skin-homing T-cells, most represented by mycosis fungoides (MF) and Sézary syndrome (SS). While national statistics exist, a detailed demographic analysis for CTCL has not been reported in most states. With fluctuating population demographics in the United States, we present an updated epidemiologic analysis for two common variants of CTCL. We compared the CTCL patient population from a tertiary referral center at the University of Arkansas for Medical Sciences to the national Surveillance, Epidemiology, and End Results (SEER) database to gain insight into trends in prevalence and incidence, and to understand the underlying disparities. Our retrospective analysis revealed demographic disparities, among young black males, in the Arkansas CTCL population, which were similarly identified in the total United States CTCL population. In addition, we mapped out the geographic distribution of CTCL patients in Arkansas to identify possible environmental associations to CTCL. Our epidemiologic analysis of a tertiary academic center in relation to national data may provide greater insight into the various determinants that influence the disparities of CTCL. ABSTRACT: Accurate demographic data are critical for comprehending and treating cutaneous T-cell lymphoma (CTCL). Our research aimed to determine the demographics and incidence trends of CTCL patients in Arkansas compared to those of the national CTCL population to recognize the underlying disparities. We collected data from 143 CTCL patients at the University of Arkansas for Medical Sciences (UAMS) and national CTCL patient data from the Surveillance, Epidemiology, and End Results (SEER) database. Our analysis revealed that males are affected more than females across all ages and races. CTCL incidence and mortality data show that CTCL has a steady increase at the national level and in Arkansas while disproportionately affecting the young black male population. In Arkansas, more than one-third of black patients presented at an advanced stage (IIB+) compared to one-fifth in the white population, and the mean age of death was more than a decade younger for black (60 years) than for white patients (74.6 years). Nationally, black male patients had the greatest mortality rate (0.5) compared to 0.32 for white males. CTCL is 2.23 and 2.38 times more prevalent in urban versus rural areas in Arkansas and nationally, respectively. Most Arkansas patients reside near major interstates and chemical-emitting sites. In conclusion, our demographic analysis of Arkansas and national CTCL patients verifies recent trends toward more aggressive presentations in young black male patients, and our geographic findings suggest possible environmental risk factors.