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Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies
Published on: February 6, 2019
Health disparities are important determinants of outcome for children with solid tumor malignancies
Mary T Austin1, Hoang Nguyen2, Jan M Eberth3
1Department of Pediatrics, Children's Cancer Hospital at the University of Texas M.D. Anderson Cancer Center, Houston, Texas; Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas; Department of Pediatric Surgery, The University of Texas Medical School at Houston, Houston, Texas.
Insights
Racial and ethnic disparities significantly impact survival rates in children with non-central nervous system (non-CNS) solid tumors. Addressing these health disparities is crucial for improving outcomes in pediatric cancer patients.
Area of Science:
- Pediatric Oncology
- Health Disparities Research
- Cancer Epidemiology
Background:
- Non-central nervous system (non-CNS) solid tumors represent a significant burden in pediatric oncology.
- Understanding health disparities is critical for equitable cancer care in children.
- Previous research has not fully elucidated the impact of race/ethnicity and socioeconomic factors on pediatric non-CNS solid tumors.
Purpose of the Study:
- To identify and analyze health disparities among children diagnosed with non-CNS solid tumors.
- To investigate the influence of these disparities on disease presentation and overall survival (OS).
Main Methods:
- Retrospective analysis of 4603 children (age ≤18 years) diagnosed with non-CNS solid tumors from the Texas Cancer Registry (1995-2009).
- Primary outcomes: disease stage and overall survival (OS).
- Covariates included demographics, socioeconomic status (SES), and proximity to treatment centers; statistical analyses used life tables, logistic, and Cox regression.
Main Results:
- Advanced disease stage at presentation was more common in younger males and Hispanic or non-Hispanic Black children (p<0.05).
- Socioeconomic status (SES) and distance to treatment did not affect initial disease stage.
- Hispanic/non-Hispanic Black children and those in the lowest SES quartile exhibited poorer 1- and 5-year survival rates (p<0.05).
- Adjusted OS varied by age, race, and stage, but not by SES or treatment distance.
Conclusions:
- Race/ethnicity is a significant determinant of survival outcomes in pediatric non-CNS solid tumors.
- Further research is needed to elucidate the mechanisms behind these racial/ethnic survival differences.
- Interventions should aim to mitigate the impact of identified disparities to improve pediatric cancer care.
Purpose:
The purpose of this study was to identify health disparities in children with non-CNS solid tumor malignancies and examine their impact on disease presentation and outcome.
Methods:
We examined the records of all children (age≤18years) diagnosed with a non-CNS solid tumor malignancy and enrolled in the Texas Cancer Registry between 1995 and 2009 (n=4603). The primary outcome measures 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, <10years 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 children with non-CNS solid tumor malignancies. Future work should better define these differences to establish mechanisms to decrease their impact.
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