Socio-economic and ethnic disparities in childhood cancer survival, Yorkshire, UK.

Autor: Cromie KJ; Leeds Institute for Data Analytics, School of Medicine, University of Leeds, Leeds, UK. medkcro@leeds.ac.uk., Hughes NF; Leeds Institute of Medical Research, School of Medicine, University of Leeds, Leeds, UK., Milner S; Leeds Institute of Medical Research, School of Medicine, University of Leeds, Leeds, UK., Crump P; Leeds Institute for Data Analytics, School of Medicine, University of Leeds, Leeds, UK., Grinfeld J; Leeds Teaching Hospitals NHS Trust, Beckett Street, Leeds, UK., Jenkins A; Sheffield Children's NHS Foundation Trust, Clarkson Street, Sheffield, UK., Norman PD; School of Geography, University of Leeds, Leeds, UK., Picton SV; Leeds Teaching Hospitals NHS Trust, Beckett Street, Leeds, UK., Stiller CA; National Disease Registration Service, Public Health England, London, UK., Yeomanson D; Sheffield Children's NHS Foundation Trust, Clarkson Street, Sheffield, UK., Glaser AW; Leeds Institute for Data Analytics, School of Medicine, University of Leeds, Leeds, UK.; Leeds Institute of Medical Research, School of Medicine, University of Leeds, Leeds, UK.; Leeds Teaching Hospitals NHS Trust, Beckett Street, Leeds, UK., Feltbower RG; Leeds Institute for Data Analytics, School of Medicine, University of Leeds, Leeds, UK.
Jazyk: angličtina
Zdroj: British journal of cancer [Br J Cancer] 2023 May; Vol. 128 (9), pp. 1710-1722. Date of Electronic Publication: 2023 Feb 24.
DOI: 10.1038/s41416-023-02209-x
Abstrakt: Background: Establishing the existence of health inequalities remains a high research and policy agenda item in the United Kingdom. We describe ethnic and socio-economic differences in paediatric cancer survival, focusing specifically on the extent to which disparities have changed over a 20-year period.
Methods: Cancer registration data for 2674 children (0-14 years) in Yorkshire were analysed. Five-year survival estimates by ethnic group (south Asian/non-south Asian) and Townsend deprivation fifths (I-V) were compared over time (1997-2016) for leukaemia, lymphoma, central nervous system (CNS) and other solid tumours. Hazard ratios (HR: 95% CI) from adjusted Cox models quantified the joint effect of ethnicity and deprivation on mortality risk over time, framed through causal interpretation of the deprivation coefficient.
Results: Increasing deprivation was associated with significantly higher risk of death for children with leukaemia (1.11 (1.03-1.20)) and all cancers between 1997 and 2001. While we observed a trend towards reducing differences in survival over time in this group, a contrasting trend was observed for CNS tumours whereby sizeable variation in outcome remained for cases diagnosed until 2012. South Asian children with lymphoma had a 15% reduced chance of surviving at least 5 years compared to non-south Asian, across the study period.
Discussion: Even in the United Kingdom, with a universally accessible healthcare system, socio-economic and ethnic disparities in childhood cancer survival exist. Findings should inform where resources should be directed to provide all children with an equitable survival outcome following a cancer diagnosis.
(© 2023. The Author(s).)
Databáze: MEDLINE
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