Table 3.
Factors influencing disparities in patient-reported outcomes for childhood cancer survivors by race/ethnicity.
| Source | Risk modulators | Results of unadjusted models | Results of adjusted models | Interpretation of findings |
|---|---|---|---|---|
| NON-HISPANIC BLACK | ||||
| (26) | SES (insurance, education, household income), age, diagnosis | OR = 0.8; 95% CI: 0.5–1.2 | OR = 0.6; 95% CI: 0.5–1.0 (females) | Less adverse mental health after accounting for risk modulators. |
| (26) | SES (insurance, education, household income), age, diagnosis | OR =1.7; 95% CI: 1.2–2.5 | OR = 1.2; 95% CI: 0.8–1.8 (females) | Higher functional impairment attenuated by risk modulators. |
| (32) | None | HR = 1.91, 95% CI: 1.58–2.30, p < 0.001 | Higher reports of pain or abnormal sensation without accounting for risk modulators. | |
| (32) | None | HR =1.85, 95% CI: 1.54–2.22, p < 0.001 | Higher reports of migraines without accounting for risk modulators. | |
| (32) | None | HR = 1.68, 95% CI: 1.40–2.02, p < 0.001 | Higher reports of other frequent headaches without accounting for risk modulators. | |
| (41) | p < 0.001 | Higher parental uncertainty without accounting for risk modulators. | ||
| HISPANIC | ||||
| (32) | None | HR =1.74, 95% CI: 1.27–2.39, p = 0.001 | Higher reports of pain or abnormal sensations without accounting for risk modulators. | |
| (32) | None | HR = 1.44, 95% CI: 1.06–1.96, p = 0.02 | Higher reports of other frequent headaches without accounting for risk modulators. | |
| (23) | Demographics, disease/treatment factors, depressive symptoms, PTSS, optimism, QOL, SES | p = 0.52 | p < 0.05 (English primary language) | Lower Post-traumatic Growth (PTG) accounting for risk modulators. |
| (33) | Diagnosis and fatigue | p = 0.02 | p < 0.01 | Lower psychosocial health after accounting for risk modulators. |
| (33) | Diagnosis and fatigue | p = 0.04 | p < 0.01 | Lower total reported quality of life after accounting for risk modulators. |
| (33) | Diagnosis and fatigue | p = 0.001 | Lower school functioning accounting for risk modulators. | |
| (33) | Diagnosis and fatigue | p = 0.01 | Lower emotional functioning accounting for risk modulators. | |
| (34) | Birthplace, education, income, stress, and treatment intensity | p < 0.0001 | β = 14.20 (3.95), p = 0.0005 (Foreign born) | Higher parent post-traumatic stress. |
| (34) | Birthplace, education, income, stress, and treatment intensity | p = 0.002 |
β = 4.35 (1.90), p =
0.02 (Foreign born); β = 4.09 (1.28), p = 0.0002 (US born) |
Higher rates of depression. |
| (39) | Family-level SES (parent education and family income) | p < 0.05 | p = 0.25 | Lower global adaptive functioning attenuated by risk modulators. |
| (39) | Family-level SES (parent education and family income) | p < 0.01 | p = 0.19 | Lower conceptual adaptive functioning attenuated by risk modulators. |
| (39) | Family-level SES (parent education and family income) | p < 0.01 | p = 0.48 | Lower social adaptive functioning attenuated by risk modulators. |
| (39) | Family-level SES (parent education and family income) | p < 0.05 | p = 0.15 | Lower practical adaptive functioning attenuated by risk modulators. |
| (42) | Age, sex, social support, family influence, PTG, depressive symptoms, treatment, self-efficacy | OR= 0.25, 95% CI: 0.13-0.45 | Higher post-traumatic growth scores accounting for risk modulators. | |
| NON-WHITE* | ||||
| (24) | Family income and caregiver education | P=0.04 | Lower emotional quality of life accounting for risk modulators. | |
| (33) | Diagnosis and fatigue | p = 0.26 | p = 0.04 | Lower psychosocial functioning after accounting for risk modulators. |
| (33) | Diagnosis and fatigue | p = 0.35 | p = 0.04 | Lower total reported quality of life after accounting for risk modulators. |
| (33) | Diagnosis and fatigue | p = 0.01 | Lower school functioning accounting for risk modulators. | |
| (44) | Demographic and clinical variables | p < 0.01 | More positive impact of cancer in all five aspects of growth accounting for risk modulators. | |
Bold denotes statistical significance with p <0.05; Reference group Non-Hispanic White or Caucasian;
*
Listed as Other or both Non-Hispanic Black and Hispanic. SES, Socioeconomic Status; PTS, Post Traumatic Stress; QOL, Quality of Life; HR, Hazards Ratio; OR, Odd Ratio.