School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Pediatr Blood Cancer. 2011 Mar;56(3):425-31. doi: 10.1002/pbc.22825.
The National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database was used to compare survival rates by race among children with common extracranial solid tumors between 1985 and 2005.
Diagnosis and outcome data were obtained from SEER. Five-year survival probabilities were calculated using the Kaplan-Meier method. Survival hazard ratios were calculated using the Cox proportional hazards model. Survival probabilities were compared among Whites, Blacks, American Indians/Alaskan Natives, and Asians/Pacific Islanders.
Five-year survival probabilities were higher for White children than for children belonging to other racial groups (77% vs. 71% for Blacks, 72% for American Indian/Alaskan Native, 72% for Asian/Pacific Islander). Male non-White children had worse 5-year survival than male White children while there were no differences in survival among females across racial groups. There was no difference when survival probabilities for Hispanic and non-Hispanic children were compared. Overall, Black children had a higher risk of death compared to White children (1.31, P < 0.05). Black children had a higher risk of death from germ cell tumors, hepatoblastoma and non-rhabdomyosarcoma soft tissue sarcomas. Asian/Pacific Islander children also had a higher risk of death overall (1.34, P < 0.05) and a higher risk of death from germ cell tumors, hepatocellular carcinoma, neuroblastoma, and Wilms tumor compared to White children.
Male children from minority groups have poorer survival from extracranial solid malignancies than White male children. Future efforts should be directed at understanding the causes of these differences and at developing practical clinical interventions to eliminate them.
美国国家癌症研究所的监测、流行病学和最终结果(SEER)数据库被用于比较 1985 年至 2005 年间常见颅外实体瘤患儿的种族间生存率。
诊断和结局数据来自 SEER。采用 Kaplan-Meier 法计算 5 年生存率。采用 Cox 比例风险模型计算生存危险比。比较白种人、黑种人、美洲印第安人/阿拉斯加原住民和亚洲/太平洋岛民之间的生存率。
白种儿童的 5 年生存率高于其他种族的儿童(黑人 71%,美洲印第安人/阿拉斯加原住民 72%,亚洲/太平洋岛民 72%)。非白种男性儿童的 5 年生存率低于白种男性儿童,而女性在不同种族组之间的生存率无差异。比较西班牙裔和非西班牙裔儿童的生存率时无差异。总体而言,黑种儿童的死亡风险高于白种儿童(1.31,P<0.05)。黑种儿童患生殖细胞瘤、肝母细胞瘤和非横纹肌肉瘤软组织肉瘤的死亡风险更高。亚洲/太平洋岛民儿童的总体死亡率也更高(1.34,P<0.05),且其患生殖细胞瘤、肝细胞癌、神经母细胞瘤和肾母细胞瘤的死亡风险也高于白种儿童。
少数族裔男性儿童的颅外实体恶性肿瘤生存率低于白种男性儿童。未来应努力了解这些差异的原因,并制定切实可行的临床干预措施来消除这些差异。