Racial and ethnic disparities in survival of US children with acute lymphoblastic leukemia: evidence from the SEER database 1988–2008
Prior studies have shown poorer survival from childhood acute lymphoblastic leukemia (ALL) among some minorities compared to non-Hispanic whites (NHW). Here, we examine whether these survival disparities have persisted and to see whether they also exist for Asian and Hispanic subgroups.
Using data from the US National Cancer Institute’s Surveillance, Epidemiology and End Results program from 1988 to 2008, we compared all natural-cause survival for children aged 19 years or under diagnosed with ALL using Cox proportional hazards models adjusted for age, diagnosis year, gender and disease immunophenotype.
Black, Hispanic and Native American children continue to have significantly poorer survival than NHW. Unlike previous studies, we found that Asian Americans also had significantly worse survival. Among Asian subgroups, Vietnamese (relative risk [RR] = 2.44, 95 % CI = 1.50–3.97) and Filipinos (RR = 1.64, 95 % CI = (1.13–2.38) had significantly poorer survival, while other East Asian groups, except Chinese, had non-significantly worse survival. Most Hispanic subgroups had RRs around 2.
Previously observed poorer prognosis for childhood ALL for some minority groups appears to be shared by most Asians as well. Further research is needed to find explanations for the poorer survival of minority children with ALL and possible treatment implications.
KeywordsChildhood cancers Ethnic disparities Cancer survival Epidemiology
This research was partially supported by Chinese University of Hong Kong Faculty of Medicine Direct Grant for Research Reference Number 2008.1.093. We wish to thank the editor and reviewer for their suggestions which have greatly improved the quality of the manuscript.
Conflict of Interest
The authors state that they have no conflicts of interest.
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