Mortality Rates Highest Among Youngest Oncology Patients, Particularly Minorities

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Researchers examined mortality in very young cancer patients, whose diagnosis is made too late.
Researchers examined mortality in very young cancer patients, whose diagnosis is made too late.

A recent study published in the Journal of Clinical Oncology investigated the overlooked population of pediatric cancer patients who die before being treated or whose diagnosis is made too late in the course of their disease to receive effective treatment. Death within 1 month of diagnosis is more likely in babies and pediatric patients of Black race or Hispanic ethnicity.1

The researchers collected data from the Surveillance, Epidemiology, and End Results (SEER) database from 36,337 pediatric cancer cases between 1992 and 2011. A total of 555 patients (1.5%) died within 1 month of cancer diagnosis.

The strongest predictor of death soon after diagnosis was age younger than 1 year. In general, babies are just challenging, clinically, because they can't tell you what they're feeling,” said Adam Green, MD, pediatric oncologist at Children's Hospital Colorado, researcher at the University of Colorado Cancer Center, and lead investigator of the study.

Another strong predictor was Black race or Hispanic ethnicity regardless of socioeconomic status. Further investigation is needed to determine if this disparity is caused by biological, cultural, or built-in factors of insurance and health care systems. Additionally, researchers discovered that the rate of early pediatric cancer deaths was underreported in clinical trials for all cancer subtypes, with some subtypes having more than 4 times as many cases of early death than previously reported.

Dr Green hopes to design a national prospective study to identify factors associated with these findings. "So that whenever a family has a child who dies of cancer within a month of diagnosis, we could contact the family to gather information about timing of symptoms and their experience accessing care. We can already act on our findings in this current study to improve early identification of these patients. But with prospective, patient-level data, we can move from understanding the scope and risk factors for early death to identifying problems in the diagnostic process we can fix."

Reference

1. Green AL, Furutani E, Ribeiro KB, Galindo CR. Death within 1 month of diagnosis in childhood cancer: an analysis of risk factors and scope of the problem. J Clin Oncol. 2017 Mar 6. doi: 10.1200/JCO.2016.70.3249 [Epub ahead of print]

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