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Comparative Study
. 2016 Sep 1;122(17):2723-30.
doi: 10.1002/cncr.30089. Epub 2016 Jun 10.

Racial disparities in the survival of American children, adolescents, and young adults with acute lymphoblastic leukemia, acute myelogenous leukemia, and Hodgkin lymphoma

Justine M Kahn  1 , Theresa H M Keegan  2 , Li Tao  3 , Renata Abrahão  3   4 , Archie Bleyer  5 , Aaron D Viny  6
Affiliations
Comparative Study

Racial disparities in the survival of American children, adolescents, and young adults with acute lymphoblastic leukemia, acute myelogenous leukemia, and Hodgkin lymphoma

Justine M Kahn et al. Cancer. .

Abstract

Background: Race-based survival in children and adolescents with hematologic malignancies has been a national challenge for decades. Large-scale investigations of age- and race-based survival trends over time in these patients have not previously been reported. The objective of this study was to investigate whether race- and age-related differences in pediatric and adolescent and young adult (AYA) leukemia and lymphoma survival persist and to what extent these differences have changed over time.

Methods: Using the Surveillance, Epidemiology, and End Results program, this study investigated the outcomes of black and white (1975-2012; n = 27,369) and white and Hispanic (1992-2012; n = 20,574) children (0-14 years old) and AYAs (15-39 years old) with acute lymphoblastic leukemia (ALL), acute myelogenous leukemia (AML), and Hodgkin lymphoma (HL). Estimates of 5- and 10-year relative survival were compared over time.

Results: Trends showed a convergence of survival for white and black children with ALL but a divergence in survival for AYA patients. Hispanic children and AYAs both suffered inferior outcomes. Trends for AML revealed persistent survival differences between black and white children and suggested worsening disparities for AYAs. Survival trends in HL revealed sustained survival differences between black and white AYA patients, whereas no differences were found in Hispanic and white patient outcomes for AML or HL.

Conclusions: Although survival for children and AYAs with ALL, AML, and HL has improved over the past 4 decades, differences persist between black, white, and Hispanic children and AYAs; survival disparities between black and white children with ALL have been nearly eliminated. Strategies aimed at identifying causality and reducing disparities are warranted. Cancer 2016. © 2016 American Cancer Society. Cancer 2016;122:2723-2730. © 2016 American Cancer Society.

Keywords: Epidemiology; Surveillance; adolescent; adolescent and young adult (AYA); and End Results (SEER); disparities; leukemia; lymphoma; pediatric; race; survival.

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Conflict of interest statement

There are no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Five-year relative survival by 5-year period of diagnosis and cancer site, SEER-9, 1975–2012. ALL, acute lymphoblastic leukemia; AML, acute myeloid leukemia, HL. Due to insufficient data, survival estimate for black children with HL for the time period 1989–1995 is not reported.
See this image and copyright information in PMC

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