小儿胶质瘤和髓母细胞瘤风险与人口统计学特征：一项泊松回归分析
Pediatric glioma and medulloblastoma risk and population demographics: a Poisson regression analysis.
作者信息
Muskens Ivo S, Feng Qianxi, Francis Stephen S, Walsh Kyle M, Mckean-Cowdin Roberta, Gauderman William J, de Smith Adam J, Wiemels Joseph L
机构信息
Department of Preventive Medicine, Center for Genetic Epidemiology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Department of Neurosurgery, Division of Neuro and Molecular Epidemiology, University of California, San Francisco, California, USA.
出版信息
Neurooncol Adv. 2020 Jul 22;2(1):vdaa089. doi: 10.1093/noajnl/vdaa089. eCollection 2020 Jan-Dec.
BACKGROUND
The incidence of pediatric brain tumors varies by race and ethnicity, but these relationships may be confounded by socioeconomic status (SES). In this study, the Surveillance, Epidemiology, and End Results Program (SEER) database was evaluated for associations between race/ethnicity and pediatric glioma and medulloblastoma risk with adjustment for SES.
METHODS
Pediatric glioma and medulloblastoma cases from the SEER database (years: 2000-2016) were included. Differences in incidence rates by ethnicity, sex, age, and SES-related factors were evaluated by calculation of age-adjusted incidence rates (AAIRs) and annual percent change (APC). SES-related factors (percentage without less than high school graduation, median household income, and percentage foreign-born) were derived from the census at the county-level (year: 2000). Multivariable Poisson regression models with adjustment for selected covariates were constructed to evaluate risk factors.
RESULTS
The highest AAIRs of pediatric glioma were observed among non-Hispanic Whites (AAIR: 2.91 per 100 000, 95%-CI: 2.84-2.99). An increasing incidence of pediatric glioma by calendar time was observed among non-Hispanic Whites and non-Hispanic Blacks (APC: 0.97%, 95%-CI: 0.28-1.68 and APC: 1.59%, 95%-CI: 0.03-3.18, respectively). Hispanic and non-Hispanic Black race/ethnicity was associated with lower risk when compared with non-Hispanic White (incidence rate ratios [IRRs]: 0.66, 95%-CI: 0.63-0.70; and 0.69, 95%-CI: 0.65-0.74, respectively). For medulloblastoma, the highest AAIR was observed for non-Hispanic Whites with a positive APC (1.52%, 95%-CI: 0.15-2.91). Hispanics and non-Hispanic Blacks had statistically significant lower IRRs compared with non-Hispanic Whites (IRRs: 0.83, 95%-CI: 0.73-0.94; and 0.72, 95%-CI: 0.59-0.87, respectively).
CONCLUSION
Non-Hispanic White race/ethnicity was associated with higher pediatric glioma and medulloblastoma IRRs in models with adjustments for SES.
背景
儿童脑肿瘤的发病率因种族和族裔而异，但这些关系可能会受到社会经济地位（SES）的混淆。在本研究中，评估了监测、流行病学和最终结果计划（SEER）数据库中种族/族裔与儿童胶质瘤和髓母细胞瘤风险之间的关联，并对SES进行了调整。
方法
纳入SEER数据库（年份：2000 - 2016年）中的儿童胶质瘤和髓母细胞瘤病例。通过计算年龄调整发病率（AAIRs）和年度百分比变化（APC）来评估种族、性别、年龄和SES相关因素在发病率上的差异。SES相关因素（高中及以上学历未完成比例、家庭收入中位数和外国出生比例）来自县级人口普查（年份：2000年）。构建了调整选定协变量的多变量泊松回归模型以评估风险因素。
结果
非西班牙裔白人中观察到儿童胶质瘤的最高AAIRs（AAIR：每10万人2.91例，95%可信区间：2.84 - 2.99）。在非西班牙裔白人和非西班牙裔黑人中观察到儿童胶质瘤发病率随时间增加（APC：0.97%，95%可信区间：0.28 - 1.68；和APC：1.59%，95%可信区间：0.03 - 3.18）。与非西班牙裔白人相比，西班牙裔和非西班牙裔黑人种族/族裔与较低风险相关（发病率比[IRRs]：分别为0.66，95%可信区间：0.63 - 0.70；和0.69，95%可信区间：0.65 - 0.74）。对于髓母细胞瘤，非西班牙裔白人的AAIR最高且APC为正值（1.52%，95%可信区间：0.15 - 2.91）。与非西班牙裔白人相比，西班牙裔和非西班牙裔黑人的IRRs在统计学上显著较低（IRRs：分别为0.83，95%可信区间：0.73 - 0.94；和0.72，95%可信区间：0.59 - 0.87）。
结论
在对SES进行调整的模型中，非西班牙裔白人种族/族裔与儿童胶质瘤和髓母细胞瘤的较高IRRs相关。
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