Socioeconomic status may be significantly associated with the disparate survival outcomes observed between children of different races and ethnicities with cancer, according to a study published in Cancer.
Although survival has improved overall, non-Hispanic black and Hispanic pediatric patients with cancer have lower survival rates compared with non-Hispanic white children. Mounting evidence suggests that socioeconomic status may be significantly associated, but how socioeconomic status mediates survival among different racial/ethnic groups has not been fully explored.
For this study, researchers accessed the Surveillance, Epidemiology, and End Results (SEER) database and evaluated the population-based cancer survival data of 31,866 pediatric patients between the ages of 0 and 19. Only black, Hispanic, and white patient cases with first primary malignancies were included in the study.
Results showed that socioeconomic status was significantly associated with lower survival among black and Hispanic children compared with white children with certain cancers, such as acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), neuroblastoma, and non-Hodgkin lymphoma (nHL).
Socioeconomic status significantly reduced the original association between race/ethnicity and survival by 44% in ALL, 28% in AML, 49% in neuroblastoma, and 34% in nHL among black children compared with white children. When comparing Hispanic children and white children, socioeconomic status reduced the association by 31% in ALL, 73% in AML, 48% in neuroblastoma, and 28% in nHL.
No associations between socioeconomic status and disparities in survival among racial and ethnic groups in Wilms tumors, osteosarcomas, and germ cell tumors were observed.
The study demonstrated that while socioeconomic status significantly contributes to, it is not fully accountable for survival disparities. The authors concluded that “a multipronged intervention approach that both addresses socioeconomic barriers to care and invests in personalized treatment regimens may ultimately be needed to fully eliminate childhood cancer survival disparities.”
Kehm RD, Spector LG, Poynter JN, Vock DM, Altekruse SF, Osypuk TL. Does socioeconomic status account for racial and ethnic disparities in childhood cancer survival? [published online August 20, 2018]. Cancer. doi: 10.1002/cncr.31560