Study on Racial and Ethnic Disparities in Pediatric Cancer Identify Difference in Risk Between Patient Subgroups

Racial and ethnic differences in incidence and risk of childhood cancer have been identified in a number of malignancies.

Findings from a study examining the age-specific incidence of pediatric cancers by a narrow versus broad age group showed that racial or ethnic minority pediatric patients have different risks than white children for different disease types.1,2

The findings of the study found that black pediatric patients and young adults had a significant reduction in the incidence of acute lymphoid leukemia (ALL; incidence ratio [IRR], 0.52; 95% CI, 0.49-0.55) versus Caucasian patients. This was most significantly observed in patients aged 1 to 7 years, as well as those aged 16 to 20 years.

In addition, Hispanic patients had a marked reduction in the overall incidence of both Hodgkin’s lymphoma (IRR, 0.50; 95% CI, 0.48-0.52) and astrocytoma (IRR, 0.54; 95% CI, 0. 52-0.56). However, this population also had an increased risk of developing ALL (IRR, 1.46; 95% CI, 1.42-1.51) versus non-Hispanic Caucasian patients. This risk was most noticeable in patients between the ages of 10 and 23 years. In addition, researchers noted a significant risk reduction across multiple tumor types in Asians and Pacific Islanders, as well as Native Americans and Alaskan Natives.

Erin L. Marcotte, PhD, MPH, an assistant professor in the Department of Pediatrics, a faculty member of epidemiology and clinical research, and a member of the Brain Tumor Program Executive Committee at the University of Minnesota Medical School, stated in a press release. In addition, unlike cancers that occur in older adults, the incidence of cancers in children and young adults shows striking variations by age at diagnosis and studying these variations has often led to a deeper understanding of the causes of childhood cancers. “

The rationale for the study came after researchers found that childhood cancer incidence in the United States is commonly reported in 5-year-old age groups, which could obscure the variation in incidence seen through a single year of age. This, coupled with the variation in incidence across racial and ethnic populations presented across broad categories as opposed to narrow age groups, inspired researchers to start the study.

Researchers used data from the Surveillance, Epidemiology, and End Results database from 2000 to 2017 to assess the frequency and age-adjusted incidence of certain cancer types in individuals from birth to age 39.

Additional study findings indicated that black pediatric patients experienced a similar incidence of non-Hodgkin’s lymphoma as white patients, although black young adults were at higher risk than white young adults as young as age 28. a higher risk of developing nephroblastoma before age 5 compared to their Caucasian counterparts.

“Some of the patterns we observed may be due to racial and ethnic differences in known risk factors for childhood cancer, such as exposure to infections and birth defects. We also know that the causes of each type of cancer in children and young adults can be vary depending on the age at which it occurs.For example, exposure to Epstein-Barr virus is associated with Hodgkin lymphoma in children younger than 10 years of age, but not in old age, so exposure to Epstein-Barr virus could may explain the higher risk of Hodgkin lymphoma in Hispanic children under the age of 10,” Marcotte concluded.

Finally, the researchers believe that the findings of this study may play a role in reducing racial and ethnic disparities in cancer risk in pediatric and young adult populations.

References

Marcotte EL, Domingues AM, Sample JM, et al. Racial and ethnic differences in childhood cancer incidence in children and young adults in the United States at one year of age. Cancer. June 21, 2021. doi:10.1002/cncr.33678Study reveals racial and ethnic differences in childhood cancer by one year of age. news item. Willy. June 21, 2021. Accessed July 27, 2021. https://bit.ly/2TJhHKg

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