Social gradient predicts survival disadvantage of African Americans/Black children with lymphoma
| Autor: | Betyna N. Berice, Nastocia T. Bafford, Malik A. Williams, Jacqueline A. Benson, Laurens Holmes, Daniel Halloran, Kirk W. Dabney, Kadedrah V. Parson |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Lymphoma White People 03 medical and health sciences 0302 clinical medicine Epidemiology Chi-square test medicine Humans Cumulative incidence 030212 general & internal medicine Child Retrospective Studies 030505 public health business.industry Proportional hazards model Hazard ratio Retrospective cohort study General Medicine United States Black or African American Relative risk Pacific islanders 0305 other medical science business Demography SEER Program |
| Zdroj: | Journal of the National Medical Association. 113(4) |
| ISSN: | 1943-4693 |
| Popis: | Background Cancer is the leading cause of disease-related mortality among children, 0–14 years, and lymphoma, a malignant neoplasm of the lymphoid cells, mostly lymphatic B and T cells is common among children. The current study aimed to assess the cumulative incidence (CmI), mortality, and survival in pediatric lymphoma. Materials and Methods A retrospective cohort was utilized to examine children, 0–19 years with lymphoma for CmI, mortality and survival from the Surveillance, Epidemiology, and End Results (SEER) data. The variables assessed included social determinants of health, namely urbanity, median household income, and race. While chi square was used to characterize study variables by race, binomial regression was employed for mortality risk. The Cox proportional hazard model was used for survival modeling. Results The CmI was higher among white children (76.67%) relative to Black/African American (AA, 13.44%), American Indian/Alaskan Native (AI/AN, 0.67%), as well as Asian/Pacific Islander (A/PI, 7.53%). With respect to mortality, there was excess mortality among Black/AA children compared to white children, Risk Ratio (RR) = 1.54, 95% CI, 1.33–1.79. Relative to whites, Blacks were 52% more likely to die, Hazard Ratio (HR) = 1.52, 95% CI, 1.30–1.78. Survival disadvantage persisted among Blacks/AA after controlling for the other confoundings, adjusted hazard ratio (aHR) = 1.54, 99% CI, 1.24–1.91. Conclusion In a large cohort of children with lymphoma, Black/AA children relative to whites presented with survival disadvantage, which was explained by urbanity and median household income, suggestive of transforming the physical and social environments in narrowing the racial differences in pediatric lymphoma survival in the US. |
| Databáze: | OpenAIRE |
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