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Racial and ethnic differences in survival of pediatric patients with brain and central nervous system cancer in the United States
Author(s) -
Siegel David A.,
Li Jun,
Ding Helen,
Singh Simple D.,
King Jessica B.,
Pollack Lori A.
Publication year - 2019
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.27501
Subject(s) - medicine , ethnic group , hazard ratio , confidence interval , cancer , proportional hazards model , survival analysis , demography , sociology , anthropology
Background Brain and central nervous system (CNS) cancer is the leading cause of cancer death among children and adolescents in the United States. Data from earlier studies suggested racial and ethnic differences in survival among pediatric patients with brain tumor. This study examined racial/ethnic difference in survival using national data and considered the effects of demographic and clinical factors. Methods Using National Program of Cancer Registries data, 1‐, 3‐, and 5‐year relative survival (cancer survival in the absence of other causes of death) was calculated for patients with brain and CNS cancer aged < 20 years diagnosed during 2001–2008 and followed up through 2013. Racial and ethnic differences in survival were measured by sex, age, economic status, stage, anatomic location, and histology. Adjusted racial and ethnic difference in 5‐year cancer specific survival was estimated using multivariable Cox regression analysis. Results Using data from 11 302 patients, 5‐year relative survival was 77.6% for non‐Hispanic white patients, 69.8% for non‐Hispanic black patients, and 72.9% for Hispanic patients. Differences in relative survival by race/ethnicity existed within all demographic groups. Based on multivariable analysis, non‐Hispanic black patients had a higher risk of death at 5 years after diagnosis compared to non‐Hispanic white patients (adjusted hazard ratio = 1.2, 95% confidence interval, 1.1–1.4). Conclusions Pediatric brain and CNS cancer survival differed by race/ethnicity, with non‐Hispanic black patients having a higher risk of death than non‐Hispanic white patients. Future investigation of access to care, social and economic barriers, and host genetic factors might identify reasons for disparities in survival.