Health disparities are important determinants of outcome for children with solid tumor malignancies

Mary T. Austin, Hoang Nguyen, Jan M. Eberth, Yuchia Chang, Andras Heczey, Dennis P. Hughes, Kevin P. Lally, Linda S. Elting

Research output: Contribution to journalArticle

Abstract

Purpose: The purpose of this studywas to identify health disparities in childrenwith non-CNS solid tumor malignancies and examine their impact on disease presentation and outcome. Methods: We examined the records of all children (age ≤ 18 years) diagnosed with a non-CNS solid tumor malignancy and enrolled in the Texas Cancer Registry between 1995 and 2009 (n = 4603). The primary outcomemeasures were disease stage and overall survival (OS). Covariates included gender, age, race/ethnicity, year of diagnosis, socioeconomic status (SES), and driving distance to the nearest pediatric cancer treatment facility. Statistical analyses included life table methods, logistic, and Cox regression. Statistical significance was defined as p < 0.05. Results: Children with advanced-stage disease were more likely to be male, b10 years old, and Hispanic or non- Hispanic Blacks (all p < 0.05). Distance to treatment and SES did not impact stage of disease at presentation. However, Hispanic and non-Hispanic Blacks and patients in the lowest SES quartile had the worst 1- and 5- year survival (all p < 0.05). The adjusted OS differed by age, race, and stage, but not SES or distance to the nearest treatment facility. Conclusions: Race/ethnicity plays an important role in survival for childrenwith non-CNS solid tumormalignancies. Future work should better define these differences to establish mechanisms to decrease their impact.

Original languageEnglish (US)
Pages (from-to)161-166
Number of pages6
JournalJournal of Pediatric Surgery
Volume50
Issue number1
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

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Keywords

  • Health disparities
  • Pediatric cancer
  • Solid tumors
  • Survival

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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