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Race, ethnicity, and socioeconomic differences in incidence of pediatric embryonal tumors in the United States
Author(s) -
Geris Jennifer M.,
Spector Logan G.
Publication year - 2020
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.28582
Subject(s) - medicine , pacific islanders , incidence (geometry) , ethnic group , demography , socioeconomic status , poisson regression , epidemiology , population , etiology , race (biology) , environmental health , physics , botany , sociology , anthropology , optics , biology
Background The etiology of childhood cancers and its social patterning remains largely unknown. Accounting for socioeconomic status (SES) when exploring the association between race/ethnicity and cancer incidence is necessary to better understand such etiology. We aimed to investigate differences in the incidence of embryonal tumors (ETs) by SES and race/ethnicity in the United States using population‐based registries of the Surveillance, Epidemiology, and End Results (SEER) Program. Procedure Children with ETs aged 0‐19 years diagnosed between 2000 and 2015 were ascertained from the census tract‐level SEER database. SES was measured using a tract‐level composite index. Incidence rate ratios (IRRs) with 95% confidence intervals (CIs) by SES quintile and race/ethnicity were estimated using multivariable Poisson regression models. Results The majority of tumors had lower incidence among nonwhite children compared with non‐Hispanic (NH) white children, after controlling for SES. NH blacks had a higher incidence of Wilms tumor than NH whites (IRR: 1.26; 95% CI, 1.13‐1.39). There was an increasing linear trend ( P = 0.0001) across increasing SES quintile for embryonal rhabdomyosarcoma after controlling for race/ethnicity. Effect modification by race/ethnicity of the relationship between SES and tumor incidence was observed for several groups. Hispanics had a significant, linear trend ( P = 0.0005) in the incidence of Wilms tumor, while Asian/Pacific Islanders experienced a significant inverse trend ( P = 0.0002). Conclusions Results from this study suggest differences in the incidence of several ETs by race/ethnicity and that these differences may be modified by SES. Investigation of potential risk factors that are socially patterned is warranted.