Low Socioeconomic Status Is Associated with Worse Survival in Children with Cancer: A Systematic Review

Gupta, Sumit; Wilejto, Marta; Pole, Jason D.; Guttmann, Astrid; Sung, Lillian

doi:10.1371/journal.pone.0089482

Cited by 98 publications

(113 citation statements)

References 48 publications

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“…Additional possible mechanisms for the disparity in outcome based on SES include: poorer tolerance and adherence to treatment and increased treatment complications among lower SES patients 26 . Determining the correct mechanisms will be an important area for future research, particularly in the current environment of healthcare reform and the need to reduce health care disparities.…”

Section: Discussionmentioning

confidence: 99%

Socioeconomic status is independently associated with overall survival in patients with multiple myeloma

Fiala

Finney

Liu

et al. 2015

Leukemia & Lymphoma

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Population-based studies suggest that black patients with multiple myeloma (MM) have a higher mortality rate than white patients; however, other studies suggest this disparity is related to socioeconomic status (SES) rather than race. To provide clarity on this topic, we reviewed 562 patients diagnosed with MM at our institution. Patients with high-SES had a median OS of 62.8 months (mos) (95% CI 43.1–82.6 mos), compared to 53.7 mos (45.2–62.3 mos) and 48.6 mos (40.4–56.8 mos) for the middle and low-SES, respectively (p =0.015). After controlling for race, age, year of diagnosis, severity of comorbidities, stem cell transplant utilization, and insurance provider, patients with low-SES had a 54 percent increase in mortality rate relative to patients with high-SES. To support our findings, we performed a similar analysis of 45,505 patients with MM from the Surveillance Epidemiology and End Results-18 (SEER) database. Low-SES is independently associated with poorer OS in MM.

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Section: Discussionmentioning

confidence: 99%

Socioeconomic status is independently associated with overall survival in patients with multiple myeloma

Fiala

Finney

Liu

et al. 2015

Leukemia & Lymphoma

View full text Add to dashboard Cite

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“…Disparities in short-term and long-term childhood cancer outcomes by race, ethnic background, and socioeconomic status also exist. 147,166,173 Research elucidating the mechanisms underlying these disparities is essential.…”

Section: Paediatric Oncologymentioning

confidence: 99%

Future cancer research priorities in the USA: a Lancet Oncology Commission

Jaffee

Dang

Agus

et al. 2017

The Lancet Oncology

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We are in the midst of a technological revolution that is providing new insights into human biology and cancer. In this era of big data, we are amassing large amounts of information that is transforming how we approach cancer treatment and prevention. Enactment of the Cancer Moonshot within the 21st Century Cures Act in the USA arrived at a propitious moment in the advancement of knowledge, providing nearly US$2 billion of funding for cancer research and precision medicine. In 2016, the Blue Ribbon Panel (BRP) set out a roadmap of recommendations designed to exploit new advances in cancer diagnosis, prevention, and treatment. Those recommendations provided a high-level view of how to accelerate the conversion of new scientific discoveries into effective treatments and prevention for cancer. The US National Cancer Institute is already implementing some of those recommendations. As experts in the priority areas identified by the BRP, we bolster those recommendations to implement this important scientific roadmap. In this Commission, we examine the BRP recommendations in greater detail and expand the discussion to include additional priority areas, including surgical oncology, radiation oncology, imaging, health systems and health disparities, regulation and financing, population science, and oncopolicy. We prioritise areas of research in the USA that we believe would accelerate efforts to benefit patients with cancer. Finally, we hope the recommendations in this report will facilitate new international collaborations to further enhance global efforts in cancer control.

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“…This study did not find race or ethnicity to be associated with early death risk. Several studies have shown an impact of socioeconomic status on diagnosis and outcomes in pediatric cancer, [4][5][6][7][8][9][10] a topic summarized in a recent systematic review 11 ; however, its relationship with risk for early death was not addressed.…”

Section: Introductionmentioning

confidence: 99%

Death Within 1 Month of Diagnosis in Childhood Cancer: An Analysis of Risk Factors and Scope of the Problem

Green

Furutani

Ribeiro

et al. 2017

JCO

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Despite advances in childhood cancer care, some patients die soon after diagnosis. This population is not well described and may be under-reported. Better understanding of risk factors for early death and scope of the problem could lead to prevention of these occurrences and thus better survival rates in childhood cancer. MethodsWe retrieved data from SEER 13 registries on 36,337 patients age 0 to 19 years diagnosed with cancer between 1992 and 2011. Early death was defined as death within 1 month of diagnosis. Socioeconomic status data for each individual's county of residence were derived from Census 2000. Crude and adjusted odds ratios and corresponding 95% CIs were estimated for the association between early death and demographic, clinical, and socioeconomic factors. ResultsPercentage of early death in the period was 1.5% (n = 555). Children with acute myeloid leukemia, infant acute lymphoblastic leukemia, hepatoblastoma, and malignant brain tumors had the highest risk of early death. On multivariable analysis, an age younger than 1 year was a strong predictor of early death in all disease groups examined. Black race and Hispanic ethnicity were both risk factors for early death in multiple disease groups. Residence in counties with lower than median average income was associated with a higher risk of early death in hematologic malignancies. Percentages of early death decreased significantly over time, especially in hematologic malignancies. ConclusionRisk factors for early death in childhood cancer include an age younger than 1 year, specific diagnoses, minority race and ethnicity, and disadvantaged socioeconomic status. The populationbased disease-specific percentages of early death were uniformly higher than those reported in cooperative clinical trials, suggesting that early death is under-reported in the medical literature. Initiatives to identify those at risk and develop preventive interventions should be prioritized.

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Low Socioeconomic Status Is Associated with Worse Survival in Children with Cancer: A Systematic Review

Cited by 98 publications

References 48 publications

Socioeconomic status is independently associated with overall survival in patients with multiple myeloma

Socioeconomic status is independently associated with overall survival in patients with multiple myeloma

Future cancer research priorities in the USA: a Lancet Oncology Commission

Death Within 1 Month of Diagnosis in Childhood Cancer: An Analysis of Risk Factors and Scope of the Problem

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