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Ethnicity, race, and socioeconomic status influence incidence of langerhans cell histiocytosis
Author(s) -
Ribeiro Karina Braga,
Degar Barbara,
Antoneli Célia Beatriz Gianotti,
Rollins Barrett,
RodriguezGalindo Carlos
Publication year - 2015
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.25404
Subject(s) - medicine , incidence (geometry) , socioeconomic status , demography , epidemiology , population , relative survival , ethnic group , relative risk , langerhans cell histiocytosis , disease , cancer registry , confidence interval , environmental health , physics , sociology , anthropology , optics
Background Langerhans cell histiocytosis (LCH) is a rare disease, and its etiology is not well understood. Population‐based studies may contribute to etiologic research by defining incidence patterns. This study was designed to evaluate the descriptive epidemiology of disseminated LCH in the United States, using data from population‐based cancer registries. Procedure We analyzed the incidence and survival of disseminated LCH in children and adolescents (0–19 years) from 18 SEER registries during 2000–2009. Age‐standardized incidence rates (ASIR) per million and rate ratios (RR) were calculated by gender, race, ethnicity, age, and socioeconomic variables (crowding, rural/urban, education, and poverty) using the SEER*Stat software 8.0.1. Relative survival (RS) estimates were calculated using Ederer II method. Results One hundred forty‐five cases of disseminated LCH were recorded; ASIR was 0.70/million per year. Lower ASIR was observed for blacks (vs. whites) (RR = 0.41, 95% CI 0.18–0.81), while higher ASIR was noted for Hispanics (vs. non‐Hispanics) (RR = 1.63, 95% CI 1.15–2.29). Risk of LCH was higher in crowded counties (RR = 1.84, 95% CI 1.31–2.58) and also in areas with low educational level (RR = 1.49, 95% CI 1.02–2.22). Five‐year relative survival was 90.0% (95% CI 83.0–94.2). Important differences in survival were noted according to gender (male: RS = 96.0 vs. female: RS = 83.4%, P = 0.029) and age (<1 year: RS = 78.5, 1–4 years: RS = 95.6%, 5–19 years: RS = 100%, P = 0.004). Conclusions This population‐based study shows significant variations in the incidence of disseminated LCH by race and ethnic group, as well as the influence of socioeconomic factors. These data may provide clues to causation and point toward the need for analytical epidemiologic studies. Pediatr Blood Cancer 2015;62:982–987. © 2015 Wiley Periodicals, Inc.