Racial and ethnic minority children and adolescents with cancer have a higher risk of death than non-Hispanic white children and adolescents, with evidence for larger disparities in survival for more treatable cancers, finds a new study from the Brown School at Washington University in St. Louis.
“The results suggest that there are modifiable racial and ethnic disparities in childhood cancer survival,” said Dr. Kim Johnson, associate professor and senior author of the study, published Feb. 25 in JAMA Pediatrics. “Continued research is needed to explain the disparities so that we can design interventions to eliminate them prior to diagnosis and throughout treatment.”
In the study of 67,061 American children from birth to age 19 with a first primary malignant cancer between 2000 and 2016, those with racial/ethnic minority status had worse cancer survival compared with non-Hispanic white children and adolescents. Among non-Hispanic black and Hispanic (all races) children and adolescents, the disparity was generally greater for cancer types with higher survival rates, such as leukemia.
“Among children and adolescents, disparities in cancer survival are well documented,” Dr. Johnson said. “However, to our knowledge, no previous study has examined how these disparities compare for cancer types of varying survivability.”
These disparities likely result from several factors, the authors say, including differences in clinical trial enrollment, later diagnosis, adherence to therapy, and disease biological characteristics. Beyond these factors, there is strong evidence that factors related to socioeconomic status may mediate some of the association between race/ethnicity and childhood and adolescent cancer survival.
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