Table 5.
Factors influencing disparities in survival for childhood cancer survivors by race/ethnicity.
| Source | Risk modulators | Results of unadjusted models | Results of adjusted models | Interpretation of findings |
|---|---|---|---|---|
| NON-HISPANIC BLACK | ||||
| (22) | US mortality rates, sex, year of diagnosis | SMR = 6.67, 95% CI: 5.84–7.59 | Higher all-cause mortality risk accounting for risk modulators. | |
| (22) | US mortality rates, sex, year of diagnosis | SMR = 10.72, 95% CI: 7.18–15.40 | Higher mortality risk of subsequent malignancy accounting for risk modulators. | |
| (25) | Age at diagnosis, time since diagnosis, cancer type | HR = 1.75, 95% CI: 1.70–1.79 | Age 0–14 HR = 1.26, 95% CI: 1.18–1.35 Age 15–35 HR= 1.88, 95% CI: 1.83–1.93 | Higher risk of any death. |
| (25) | Age at diagnosis, time since diagnosis, cancer type | HR = 2.13, 95% CI: 1.85–2.46 | Age 0–14 HR = 1.08, 95% CI: 0.62–1.89 Age 15–34 HR = 1.33, 95% CI: 0.60–2.95 |
Higher cardiovascular disease death attenuated by risk modulators. |
| (31) | Clinical/demographic variables | RR = 1.5, 95% CI: 1.1–2.0, p = 0.004 | Higher all-cause relative mortality rate accounting for risk modulators. | |
| (31) | Clinical/demographic variables and treatment | RR = 1.4, 95% CI: 1.1–1.9, p = 0.008 | Higher all cause relative mortality rate accounting for risk modulators. | |
| (31) | Clinical/demographic variables, treatment, and SES (education, income, & insurance) | RR = 1.0, 95% CI: 0.8–1.4, p = 0.88 | Higher all-cause relative mortality rate accounting for risk modulators. | |
| (31) | Clinical/demographic variables, treatment, and SES (education, income, & insurance) | SMR = 0.6, 95% CI: 0.4–0.8, p < 0.001 | Higher all-cause standardized mortality rate accounting for risk modulators. | |
| (31) | Clinical/demographic variables, treatment, and SES (education, income, & insurance) and SVRF (obesity, diabetes, hypertension, and dyslipidemia) | SMR = 0.6, 95% CI: 0.4–0.8, p < 0.001 | Higher all-cause standardized mortality rate accounting for risk modulators. | |
| HISPANIC | ||||
| (31) | Clinical/demographic variables, treatment, and SES (education, income, & insurance) and SVRF (obesity, diabetes, hypertension, and dyslipidemia) | SMR = 0.7, 95% CI: 0.6–1.0, p = 0.03 | Higher all-cause standardized mortality rate accounting for risk modulators. | |
| NON-WHITE* | ||||
| (30) | Neighborhood-level SES index** | Direct HR = 1.45, 95% CI: 1.15–1.84, p < 0.01 | Indirect HR = 1.15, 95%CI: 1.03–1.29, p = 0.01 | Higher hazard of death for Acute Myeloid Leukemia survivors. |
| (30) | Neighborhood-level SES index** | Direct HR = 1.80, 95% CI: 1.42–2.30, p < 0.0001 | Indirect HR = 1.08, 95% CI: 0.98–1.20, p = 0.12 | Higher hazard of death for Astrocytoma survivors attenuated by risk modulators. |
| (30) | Neighborhood-level SES index** | Direct HR = 1.41, 95% CI: 1.11–1.78, p < 0.01 | Indirect HR = 1.09, 95% CI; 0.97–1.22, p = 0.14 | Higher hazard of death for non-astrocytoma CNS tumors attenuated by risk modulators. |
| (40) | None | MIR = 27.4%, p = 0.001 | Higher mortality to incidence without accounting for risk modulators. | |
Bold denotes statistical significance with p < 0.05; Reference group Non-Hispanic White or Caucasian;
*
Listed as other or Non-White;
**
Tract SES Index, National Cancer Institute Census Tract-level socioeconomic status (SES) Index. CVRF, Cardiovascular Risk Factor; SES, Socioeconomic Status; HR, Hazards Ratio; OR, Odd Ratio. SMR, Standard Mortality Ration; RR, Relative Ratio; MIR, Mortality to Incidence Ratio.