Table 3.
Excess Risk of All-Cause and Cause-Specific Mortality Across Racial/Ethnic Groups of Childhood Cancer Survivors: Relative Standardized Mortality Rate
| All-Cause | Subsequent Neoplasm* | Subsequent Malignancy | Cardiac Cause | |||||
|---|---|---|---|---|---|---|---|---|
| Relative SMR (95% CI) | P | Relative SMR (95% CI) | P | Relative SMR (95% CI) | P | Relative SMR (95% CI) | P | |
| Adjusted for clinical/demographic variables† | ||||||||
| NHW | Ref | Ref | Ref | Ref | ||||
| NHB | 0.8 (0.6 to 1.1) | .15 | 1.2 (0.7 to 1.9) | .56 | 0.9 (0.5 to 1.7) | .85 | 0.8 (0.3 to 2.4) | .70 |
| Hispanic | 1.0 (0.7 to 1.2) | .71 | 0.9 (0.5 to 1.6) | .66 | 0.8 (0.4 to 1.6) | .52 | 2.0 (0.9 to 4.6) | .09 |
| Adjusted for clinical/demographic variables and treatment‡ | ||||||||
| NHW | Ref | Ref | Ref | Ref | ||||
| NHB | 0.8 (0.6 to 1.0) | .09 | 1.1 (0.7 to 1.9) | .62 | 0.9 (0.5 to 1.7) | .80 | 0.8 (0.3 to 2.4) | .66 |
| Hispanic | 0.9 (0.7 to 1.2) | .51 | 0.8 (0.5 to 1.5) | .58 | 0.8 (0.4 to 1.5) | .45 | 1.9 (0.8 to 4.3) | .15 |
| Adjusted for clinical/demographic variables, treatment, and SES§ | ||||||||
| NHW | Ref | Ref | Ref | Ref | ||||
| NHB | 0.6 (0.4 to 0.8) | < .001 | 0.9 (0.5 to 1.6) | .71 | 0.7 (0.4 to 1.4) | .35 | 0.6 (0.2 to 1.9) | .42 |
| Hispanic | 0.8 (0.6 to 1.0) | .05 | 0.7 (0.4 to 1.3) | .22 | 0.7 (0.3 to 1.3) | .23 | 1.6 (0.7 to 3.7) | .30 |
| Adjusted for clinical/demographic variables, treatment, SES, and CVRF|| | ||||||||
| NHW | Ref | Ref | Ref | Ref | ||||
| NHB | 0.6 (0.4 to 0.8) | < .001 | 0.9 (0.5 to 1.6) | .76 | 0.7 (0.4 to 1.4) | .39 | 0.5 (0.2 to 1.3) | .15 |
| Hispanic | 0.7 (0.6 to 1.0) | 0.03 | 0.7 (0.4 to 1.2) | .21 | 0.7 (0.3 to 1.3) | .23 | 1.7 (0.7 to 3.9) | .25 |
NOTE. Rates for Hispanic are available from the Centers for Disease Control and Prevention only for years 1999 and after. We used models to estimate the Hispanic rates before 1999, with the assumption that Hispanics are very similar to whites in terms of how the mortality rates have changed.
Abbreviations: CVRF, cardiovascular risk factors; NHB, non-Hispanic black; NHW, non-Hispanic white; Ref, reference; SES, socioeconomic status; SMR, standardized mortality ratio.
Subsequent neoplasm included both malignancies and benign subsequent neoplasms.
Clinical/demographic variables include sex, age at diagnosis, diagnosis, treatment era, and attained age as natural cubic splines.
Treatment includes radiation therapy, alkylating agent cyclophosphamide equivalent dose, and anthracycline score.
SES includes education, annual household income, and health insurance as time-dependent variables.
||CVRF include obesity, diabetes, hypertension, and dyslipidemia.