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Pediatric hodgkin lymphoma: disparities in survival by race
Karishma Khullar1, Zorimar Rivera-Núñez1, Sachin R Jhawar2
1Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.
Insights
Black children with Hodgkin lymphoma (HL) have lower overall survival rates compared to White children. This study highlights racial disparities in pediatric cancer outcomes, emphasizing the need for further investigation into contributing factors.
Area of Science:
- Oncology
- Epidemiology
- Health Disparities
Background:
- Pediatric Hodgkin lymphoma (HL) survival rates have improved, but disparities persist.
- Understanding racial differences in outcomes is crucial for equitable cancer care.
Purpose of the Study:
- To investigate factors contributing to racial disparities in overall survival (OS) among pediatric Hodgkin lymphoma patients.
- To analyze survival data based on race in patients diagnosed with stage I-IV HL.
Main Methods:
- Utilized the National Cancer DataBase (NCDB) from 2004-2015.
- Included patients aged 21 years or younger diagnosed with stage I-IV HL.
- Employed a multivariable Cox proportional hazards model for survival analysis.
Main Results:
- Black pediatric HL patients had a 5-year OS of 91.5% compared to 95.9% in White patients (p < .0001).
- Black race was significantly associated with decreased OS (HR=1.50; 95% CI: 1.12-1.99; p < .01) after adjusting for confounders.
- Poorer OS in Black patients was observed across different age strata (≤15, 16-18, >18 years).
Conclusions:
- Black pediatric Hodgkin lymphoma patients experienced significantly lower overall survival compared to White patients.
- Racial disparities in survival outcomes for pediatric HL warrant further investigation and targeted interventions.
Abstract:
The purpose of this study was to examine factors associated with disparities in overall survival (OS) by race in pediatric Hodgkin Lymphoma (HL) patients. We evaluated clinical features and survival among patients ≤21 years of age diagnosed with stage I-IV HL from 2004 to 2015 from the National Cancer DataBase (NCDB) using a multivariable Cox proportional hazards model. Among 11,546 patients with pediatric HL, 9285 patients met eligibility criteria. Black patients experienced a 5-year OS of 91.5% vs 95.9% in White patients (p < .0001). After adjusting for confounders, Black race was associated with a significantly decreased OS (HR = 1.50; 95% CI: 1.12-1.99; p < .01). In stratified analysis by ages ≤15 years, 16-18 years, and >18 years, Black race was associated with poorer OS among compared to Whites with rates of 95.4% vs 97.7%, 87.1% vs 96.1%, and 91.6% vs 94.6% respectively. Overall, Black pediatric HL patients had lower overall survival in this study.
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