Racial and Ethnic Disparities in the Pediatric Hodgkin Lymphoma Population

Grubb, William; Neboori, Hanmanth J.; Diaz, Abigail; Li, H.; Kwon, Deukwoo; Panoff, Joseph

doi:10.1002/pbc.25802

Cited by 27 publications

(23 citation statements)

References 23 publications

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“…Independently, those patients in areas of highest poverty had decreased overall survival when compared with areas of lower poverty. Our findings in pediatric brain tumors are consistent with previous studies showing disparities in outcomes for racial and ethnic minorities in other adult and pediatric cancers 3,6,7 . These prior studies have shown Black race and Hispanic ethnicity to be associated with poorer survival and/or later stage disease at presentation, although one study showed some mitigation by accounting for socioeconomic measures 7 .…”

Section: Discussionsupporting

confidence: 92%

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Population-Based Analysis of Demographic and Socioeconomic Disparities in Pediatric CNS Cancer Survival in the United States

Fineberg

Zahedi

Eguchi

et al. 2020

Sci Rep

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Previous studies have demonstrated effects of racial and socioeconomic factors on survival of adults with cancer. While less studied in the pediatric population, data exist demonstrating disparities of care and survival in pediatric oncology patients based on socioeconomic and racial/ethnic factors. Brain cancers recently overtook leukemia as the number one cause of childhood cancer fatalities, but demographic and socioeconomic disparities in these tumors have not been adequately studied. We obtained data from the SeeR program of the national cancer institute (nci). We selected patients under 19 years of age with central nervous system (CNS) cancers diagnosed between 2000 and 2015. We included patient demographics, tumor characteristics, treatment, and socioeconomic characteristics as covariates in the analysis. We measured overall survival and extent of disease at diagnosis. We saw that Black and Hispanic patients overall had a higher risk of death than non-Hispanic White patients on multivariable analysis. On stratified analysis, Black and Hispanic patients with both metastatic and localized disease at diagnosis had a higher risk of death compared to White, non-Hispanic patients, although the difference in Black patients was not significant after adjusting for mediating factors. However, our findings on extent of disease at diagnosis demonstrated that neither Black race nor Hispanic ethnicity increased the chance of metastatic disease at presentation when controlling for mediating variables. In summary, racial and ethnic disparities in childhood CNS tumor survival appear to have their roots at least partially in post-diagnosis factors, potentially due to the lack of access to high quality care, leading to poorer overall outcomes.

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Section: Discussionsupporting

confidence: 92%

“…Previous studies have demonstrated effects of racial and socioeconomic factors on survival of adults with cancer [1][2][3] . For instance, it has been shown that access to private insurance compared to Medicaid or no insurance positively affects the prognosis of adult glioblastoma patients leading to better overall survival 4 .…”

mentioning

confidence: 99%

Population-Based Analysis of Demographic and Socioeconomic Disparities in Pediatric CNS Cancer Survival in the United States

Fineberg

Zahedi

Eguchi

et al. 2020

Sci Rep

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“…First, we replicated results from prior studies that whites have a significant survival advantage over blacks and Hispanics for several childhood cancers including leukemias, 2, 3 lymphomas, 4, 5 CNS tumors, 6 neuroblastoma, 7 and NRSTS. 9 In no instance was survival among whites significantly worse than that of either black or Hispanic children.…”

Section: Discussionsupporting

confidence: 79%

“…1 Compared to non-Hispanic white (white) children, non-Hispanic black (black) and Hispanic children experience lower survival from many cancers including leukemias, 2, 3 lymphomas, 4, 5 central nervous system (CNS) tumors, 6 and extracranial solid tumors. 7–9 The underlying causes of racial/ethnic survival differences are not well understood, and may vary by cancer type.…”

Section: Introductionmentioning

confidence: 99%

Does socioeconomic status account for racial and ethnic disparities in childhood cancer survival?

Kehm

Spector

Poynter

et al. 2018

Cancer

115

136

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“…Research on outcomes from childhood lymphomas using cancer registration data has been recently intensified and shows persisting disparities even in states with high‐quality health care systems and mandatory health coverage . Nonmodifiable determinants, such as age, sex, race, and ethnicity, might also play a role over and beyond health care delivery.…”

Section: Introductionmentioning

confidence: 99%

Mortality and survival patterns of childhood lymphomas: geographic and age‐specific patterns in Southern‐Eastern European and SEER/US registration data

Karalexi

Georgakis

Dessypris

et al. 2016

Hematological Oncology

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Childhood (0-14 years) lymphomas, nowadays, present a highly curable malignancy compared with other types of cancer. We used readily available cancer registration data to assess mortality and survival disparities among children residing in Southern-Eastern European (SEE) countries and those in the United States. Average age-standardized mortality rates and time trends of Hodgkin (HL) and non-Hodgkin (NHL; including Burkitt [BL]) lymphomas in 14 SEE cancer registries (1990-2014) and the Surveillance, Epidemiology, and End Results Program (SEER, United States; 1990-2012) were calculated. Survival patterns in a total of 8918 cases distinguishing also BL were assessed through Kaplan-Meier curves and multivariate Cox regression models. Variable, rather decreasing, mortality trends were noted among SEE. Rates were overall higher than that in SEER (1.02/10 ), which presented a sizeable (-4.8%, P = .0001) annual change. Additionally, remarkable survival improvements were manifested in SEER (10 years: 96%, 86%, and 90% for HL, NHL, and BL, respectively), whereas diverse, still lower, rates were noted in SEE. Non-HL was associated with a poorer outcome and an amphi-directional age-specific pattern; specifically, prognosis was inferior in children younger than 5 years than in those who are 10 to 14 years old from SEE (hazard ratio 1.58, 95% confidence interval 1.28-1.96) and superior in children who are 5 to 9 years old from SEER/United States (hazard ratio 0.63, 95% confidence interval 0.46-0.88) than in those who are 10 to 14 years old. In conclusion, higher SEE lymphoma mortality rates than those in SEER, but overall decreasing trends, were found. Despite significant survival gains among developed countries, there are still substantial geographic, disease subtype-specific, and age-specific outcome disparities pointing to persisting gaps in the implementation of new treatment modalities and indicating further research needs.

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Racial and Ethnic Disparities in the Pediatric Hodgkin Lymphoma Population

Abstract: Racial/ethnic disparities persist in the pediatric HL population despite modern treatment; underlying causes of these disparities are complex and need further examination.

Cited by 27 publications

References 23 publications

Population-Based Analysis of Demographic and Socioeconomic Disparities in Pediatric CNS Cancer Survival in the United States

Population-Based Analysis of Demographic and Socioeconomic Disparities in Pediatric CNS Cancer Survival in the United States

Does socioeconomic status account for racial and ethnic disparities in childhood cancer survival?

Mortality and survival patterns of childhood lymphomas: geographic and age‐specific patterns in Southern‐Eastern European and SEER/US registration data

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