Judy Y Ou, Heydon K Kaddas, Todd A Alonzo, Logan G Spector, Negar Fallahazad, Emily Owens, Lindsay J Collin, Adam L Green, Anne C Kirchhoff
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Logistic regressions calculated odds ratios for late-stage diagnosis and by race within tumor subtype.</p><p><strong>Results: </strong>In total, 5,956 patients with Hodgkin lymphoma and 2,800 patients with RMS were included. Late-stage diagnosis of Hodgkin lymphoma 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 Hodgkin lymphoma: ORD vs. R&L = 1.64 (1.34-2.01), Untyped: ORD vs. R&L = 1.30 (1.04-1.63)]. Late-stage RMS 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 Hodgkin lymphoma 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) dissimilarity indices. 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 Child Opportunity Index (OR = 1.21; 95% CI = 1.02-1.45).</p><p><strong>Conclusions: </strong>Novel markers of community deprivation, such as redlining and racial segregation, were correlated with cancer outcomes for children with Hodgkin lymphoma and RMS in this first disparities study using Children's Oncology Group registries.</p><p><strong>Impact: </strong>The interplay of multilevel risk factors provides important consideration for efforts to improve early detection of pediatric cancer diagnosis.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":"1327-1338"},"PeriodicalIF":3.7000,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11446656/pdf/","citationCount":"0","resultStr":"{\"title\":\"Sociodemographic and Socioeconomic Factors Correlate with Late-Stage Pediatric Hodgkin Lymphoma and Rhabdomyosarcoma: A Report from the Children's Oncology Group Registries.\",\"authors\":\"Judy Y Ou, Heydon K Kaddas, Todd A Alonzo, Logan G Spector, Negar Fallahazad, Emily Owens, Lindsay J Collin, Adam L Green, Anne C Kirchhoff\",\"doi\":\"10.1158/1055-9965.EPI-24-0510\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>We examined the association between late-stage diagnosis and individual- and community-level sociodemographic and socioeconomic characteristics among patients with pediatric Hodgkin lymphoma and rhabdomyosarcoma (RMS).</p><p><strong>Methods: </strong>We obtained Children's Oncology Group data from 1999 to 2021 including summary stage [local (L), regional (R), and distant (D)], tumor subtype, demographics, and ZIP Code at diagnosis. 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引用次数: 0
摘要
背景：我们研究了小儿霍奇金淋巴瘤（HL）和横纹肌肉瘤（RMS）患者晚期诊断与个人和社区特征之间的关系：我们研究了小儿霍奇金淋巴瘤（HL）和横纹肌肉瘤（RMS）患者的晚期诊断与个人和社区特征之间的关系：我们获得了儿童肿瘤学组（Children's Oncology Group，COG）1999-2021 年的数据，包括诊断时的简要分期（局部分期（L）、区域分期（R）、远处分期（D））、肿瘤亚型、人口统计学特征和邮政编码。我们将邮政编码与县级红线分数（C,D=最大红线）、儿童机会指数（COI）和种族隔离度量（种族差异指数（DI））联系起来。逻辑回归计算了晚期诊断的几率比，以及肿瘤亚型中的种族几率比：结果：共纳入 5,933 例 HL 和 2,800 例 RMS 患者。HL的晚期诊断与黑人种族（ORDistant(D) vs regional/local(R&L)=1.38 [1.13-1.68]）、无保险（ORD vs R&L=1.38 [1.09-1.75]）和亚型（结节性硬化 vs 其他HL：ORD vs R&L=1.64 [1.34-2.01]，未分型：ORD vs R&L=1.30[1.04-1.63]）。晚期横纹肌肉瘤与双语家庭（ORDistant/ regional(D&R) vs local(L)=2.66 [1.03-6.91]）和肿瘤类型（肺泡型 vs 胚胎型 ORD vs R&L=6.16 [5.00-7.58]）相关。与晚期HL相关的社区因素是黑人（OR80-100%=1.83；95%CI=1.11-3.02）和西班牙裔（OR60-79%=1.30；95%CI=1.05-1.60）DI较高。晚期RMS诊断与县内更多的红线人口普查区（OR=1.54；95% CI=1.02-2.35）和低/极低COI（OR=1.21；95% CI=1.02-1.45）有关：结论：在这项首次使用COG登记进行的差异研究中，社区贫困的新标志物（如红线和种族隔离）可能会影响HL和RMS患儿的癌症预后：影响：多层次风险因素的相互作用为改善儿科癌症诊断的早期发现提供了重要的考虑因素。
Sociodemographic and Socioeconomic Factors Correlate with Late-Stage Pediatric Hodgkin Lymphoma and Rhabdomyosarcoma: A Report from the Children's Oncology Group Registries.
Background: We examined the association between late-stage diagnosis and individual- and community-level sociodemographic and socioeconomic characteristics among patients with pediatric Hodgkin lymphoma and rhabdomyosarcoma (RMS).
Methods: We obtained Children's Oncology Group data from 1999 to 2021 including summary stage [local (L), regional (R), and distant (D)], tumor subtype, demographics, and ZIP Code at diagnosis. We linked ZIP Codes to county-level redlining scores (C, D = greatest redlining), the Child Opportunity Index, and measures of segregation (racial dissimilarity indices). Logistic regressions calculated odds ratios for late-stage diagnosis and by race within tumor subtype.
Results: In total, 5,956 patients with Hodgkin lymphoma and 2,800 patients with RMS were included. Late-stage diagnosis of Hodgkin lymphoma 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 Hodgkin lymphoma: ORD vs. R&L = 1.64 (1.34-2.01), Untyped: ORD vs. R&L = 1.30 (1.04-1.63)]. Late-stage RMS 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 Hodgkin lymphoma 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) dissimilarity indices. 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 Child Opportunity Index (OR = 1.21; 95% CI = 1.02-1.45).
Conclusions: Novel markers of community deprivation, such as redlining and racial segregation, were correlated with cancer outcomes for children with Hodgkin lymphoma and RMS in this first disparities study using Children's Oncology Group registries.
Impact: The interplay of multilevel risk factors provides important consideration for efforts to improve early detection of pediatric cancer diagnosis.
期刊介绍：
Cancer Epidemiology, Biomarkers & Prevention publishes original peer-reviewed, population-based research on cancer etiology, prevention, surveillance, and survivorship. The following topics are of special interest: descriptive, analytical, and molecular epidemiology; biomarkers including assay development, validation, and application; chemoprevention and other types of prevention research in the context of descriptive and observational studies; the role of behavioral factors in cancer etiology and prevention; survivorship studies; risk factors; implementation science and cancer care delivery; and the science of cancer health disparities. Besides welcoming manuscripts that address individual subjects in any of the relevant disciplines, CEBP editors encourage the submission of manuscripts with a transdisciplinary approach.
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