Full Citation
Title: Sociodemographic Factors Correlate with Late Stage Pediatric Hodgkin Lymphoma and Rhabdomyosarcoma: A Report from the Children’s Oncology Group Registries
Citation Type: Journal Article
Publication Year: 2024
ISBN: 240510/3481523
ISSN: 1055-9965
DOI: 10.1158/1055-9965.EPI-24-0510
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Abstract: <p>Background: We examined association between late stage diagnosis and individual- and community-level characteristics among pediatric Hodgkin lymphoma (HL) and rhabdomyosarcoma (RMS) patients. Methods: We obtained Children’s Oncology Group (COG) data from 1999-2021 including summary stage (local (L), regional (R), distant (D)), tumor subtype, demographics, and ZIP code at diagnosis. We linked ZIP codes to county-level redlining scores (C,D=greatest redlining), Child Opportunity Index (COI), and measures of segregation (racial dissimilarity indices (DI)). Logistic regressions calculated odds ratios for late stage diagnosis, and by race within tumor subtype. Results: 5,933 HL and 2,800 RMS patients were included. Late stage diagnosis of HL was correlated with Black race (ORDistant(D) vs regional/local(R&L)=1.38 [1.13-1.68]), being uninsured (ORD vs R&L=1.38 [1.09-1.75]), and subtype (Nodular sclerosis vs Other HL: ORD vs R&L=1.64 [1.34-2.01], Untyped: ORD vs R&L=1.30 [1.04-1.63]). Late stage rhabdomyosarcoma was correlated with bilingual households (ORDistant/regional(D&R) vs local(L)=2.66 [1.03-6.91]) and tumor type (Alveolar vs Embryonal ORD vs R&L=6.16 [5.00-7.58]. Community-level factors associated with late stage HL were greater Black (OR80-100%=1.83; 95% CI=1.11-3.02) and Hispanic (OR60-79%=1.30; 95%CI=1.05-1.60) DI. Late stage diagnosis for RMS was associated with more redlined census tracts within counties (OR=1.54; 95% CI =1.02-2.35) and low/very low COI (OR=1.21; 95% CI=1.02-1.45). Conclusion: Novel markers of community deprivation, such as redlining and racial segregation, likely affect cancer outcomes for children with HL and RMS in this first disparities study using COG registries. Impact: The interplay of multilevel risk factors provides important consideration for efforts to improve early detection of pediatric cancer diagnosis.</p>
Url: https://dx.doi.org/10.1158/1055-9965.EPI-24-0510
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Authors: Ou, Judy Y.; Kaddas, Heydon K.; Alonzo, Todd A.; Spector, Logan G.; Fallahazad, Negar; Owens, Emily; Collin, Lindsay J.; Green, Adam L.; Kirchhoff, Anne C.
Periodical (Full): Cancer Epidemiology, Biomarkers & Prevention
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