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 Researchers examined data on 31,866 black, Hispanic, and white
children who were diagnosed with 12 types of cancer between 2000 and
2011 when they were no more than 19 years old. Through the end of
2012, rates of death from all causes ranged from 5.2 percent among
kids with Hodgkin lymphoma, an immune system cancer, to 33.8 percent
among children with acute myeloid leukemia, a cancer of the blood
and bone marrow.
For nine cancers, black children were significantly more likely to
die that white kids, with an increased risk ranging from 38 percent
with neuroblastoma, a form of brain cancer, to 95 percent with
astocytoma, a different type of brain cancer.
With six cancers, Hispanic kids were more likely to die than white
children, with an increased risk ranging from 31 percent with
neuroblastoma to 65 percent with non-Hodgkin lymphoma, an immune
system cancer.
"Racial and ethnic differences in childhood cancer survival have
long been known, and there has been some research indicating that
socioeconomic status could explain disparities," said lead study
author Rebecca Kehm, of the Columbia University Mailman School of
Public Health in New York City.
"However, our study is the first to use statistical methods that put
numbers to the relative contribution of SES to survival disparities
for different types of childhood cancer," Kehm, who completed the
research at the University of Minnesota School of Public Health,
said by email.
Socioeconomic status is a measure of class or standing in society
that often includes income, education and occupation. For kids, it's
often based on their parents' circumstances.
When researchers accounted for socioeconomic status in the current
study, it explained much of the difference in survival rates for
acute lymphoblastic leukemia, a form of bone marrow cancer; acute
myeloid leukemia, a different bone marrow cancer; neuroblastoma; and
non-Hodgkin lymphoma.
For black children compared with white kids, factoring in
socioeconomic status reduced the original association between race
and survival for these four cancers by 44 percent, 28 percent, 49
percent and 34 percent, respectively, the study found.
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For Hispanic children, socioeconomic status reduced the original
association between ethnicity and survival for these four cancers by
31 percent, 73 percent, 48 percent and 28 percent, respectively.
"Race is a socially constructed taxonomy that does not in itself
cause health. However, there are a number of factors that are
associated with one's race that can influence health," Kehm said.
"For example, exposure to racial discrimination can cause a
physiological stress response and a weathering effect on one's
health. There are also genetic variants that are associated with
ancestry that have been linked with different health outcomes,
including certain types of cancer."
The study wasn't a controlled experiment designed to prove whether
or how socioeconomic status might directly impact survival odds for
childhood cancer patients, researchers note in the journal Cancer.
It's possible that for some types of childhood cancer, the biology
of drug processing or tumor biology that differs by ancestry might
be more important than socioeconomic status, the study authors
write.
Still, the findings add to the large body of evidence linking
factors like limited education, low income and issues with the
access and affordability of care to worse survival rates for cancer,
said Dr. Adam Green, an associate professor at the University of
Colorado School of Medicine and a pediatric oncologist at Children's
Hospital Colorado in Aurora.
"Socioeconomic factors like poverty do make it harder for black and
Hispanic children to survive some of the most common childhood
cancers," Green, coauthor of an accompanying editorial, said by
email. "And it's doubly important that we address these factors,
because there seem to be other factors beyond socioeconomic status
that make survival for these groups harder as well, which may be
harder to change."
SOURCE: https://bit.ly/2N5KbFd and https://bit.ly/2MmTggK Cancer,
online August 20, 2018.
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