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. 2011 Jan 1;29(1):76-82.
doi: 10.1200/JCO.2010.29.6103. Epub 2010 Nov 22.

Racial and ethnic disparities in risk and survival in children with neuroblastoma: a Children's Oncology Group study

Tara O Henderson  1 , Smita Bhatia, Navin Pinto, Wendy B London, Patrick McGrady, Catherine Crotty, Can-Lan Sun, Susan L Cohn
Affiliations

Racial and ethnic disparities in risk and survival in children with neuroblastoma: a Children's Oncology Group study

Tara O Henderson et al. J Clin Oncol. .

Abstract

Purpose: Although health disparities are well-described for many cancers, little is known about racial and ethnic disparities in neuroblastoma. To evaluate differences in disease presentation and survival by race and ethnicity, data from the Children's Oncology Group (COG) were analyzed.

Patients and methods: The racial/ethnic differences in clinical and biologic risk factors, and outcome of patients with neuroblastoma enrolled on COG ANBL00B1 between 2001 and 2009 were investigated.

Results: A total of 3,539 patients (white, 72%; black, 12%; Hispanic, 12%; Asian, 4%; and Native American, < 1%) with neuroblastoma were included. The 5-year event-free survival (EFS) rates were 67% for whites (95% CI, 65% to 69%), 69% for Hispanics (95% CI, 63% to 74%), 62% for Asians (95% CI, 51% to 71%), 56% for blacks (95% CI, 50% to 62%), and 37% for Native American (95% CI, 17% to 58%). Blacks (P < .001) and Native Americans (P = .04) had a higher prevalence of high-risk disease than whites, and significantly worse EFS (P = .01 and P = .002, respectively). Adjustment for risk group abrogated these differences. However, closer examination of the EFS among high-risk patients who remained event free for 2 years or longer, revealed a higher prevalence of late-occurring events among blacks compared with whites (hazard ratio, 1.5; 95% CI, 1.0 to 2.3; P = .04).

Conclusion: Black and Native American patients with neuroblastoma have a higher prevalence of high-risk disease, accounting for their worse EFS when compared with whites. The higher prevalence of late-occurring events among blacks with high-risk disease suggests that this population may be more resistant to chemotherapy. Studies focused on delineating the genetic basis for the racial disparities observed in this study are planned.

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Conflict of interest statement

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

Figures

Fig 1.
Fig 1.
Formation of the analytic cohort.
Fig 2.
Fig 2.
Overall survival (OS) and event-free survival (EFS) curves for the entire cohort of patients (n = 3,539) with numbers of patients at risk over time.
Fig 3.
Fig 3.
(A) Overall and (B) event-free survival by race and ethnicity with numbers of patients at risk over time. Non-H, non-Hispanic; NA, Native American.
See this image and copyright information in PMC

References

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