University of Washington School of Medicine, Seattle, WA, USA.
Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
J Neurooncol. 2021 May;152(3):451-466. doi: 10.1007/s11060-021-03738-2. Epub 2021 Mar 28.
Primary central nervous system (CNS) tumors are among the most common and lethal types of cancer in children. However, the existence of health disparities in CNS tumors by race or ethnicity remains poorly understood. This systematic review sought to determine whether racial and ethnic disparities in incidence, healthcare access, and survival exist among pediatric patients diagnosed with CNS tumors.
A search of MEDLINE, Embase, CINAHL, Web of Science, and Scopus was conducted. Inclusion criteria selected for studies published between January 1, 2005 and July 15, 2020 that focused on pediatric populations in the US, evaluated for potential differences based on racial or ethnic backgrounds, and focused on CNS tumors. A standardized study form was used to collect study information, population of interest, research design, and quality of analysis, sample size, participant demographics, pathology evaluated, and incidence or outcomes observed.
A total of 30 studies were inlcuded. Studies suggest White children may be more likely to be diagnosed with a CNS tumor and Hispanic children to present with advanced-stage disease and have worse outcomes. The degree of influence derived from socioeconomic factors is unclear. This review was limited by few available studies that included race and ethnicity as a variable, the overlap in databases used, and unclear categorization of race and ethnicity.
This review identified notable and at times contradicting variations in racial/ethnic disparities among children with CNS tumors, suggesting that the extent of these disparities remains largely unknown and prompts further research to improve health equity.
原发性中枢神经系统(CNS)肿瘤是儿童中最常见和最致命的癌症类型之一。然而,种族或族裔之间的 CNS 肿瘤健康差异仍然知之甚少。本系统评价旨在确定诊断为 CNS 肿瘤的儿科患者的发病率、医疗保健获取和生存率是否存在种族和族裔差异。
对 MEDLINE、Embase、CINAHL、Web of Science 和 Scopus 进行了检索。纳入标准选择了 2005 年 1 月 1 日至 2020 年 7 月 15 日期间发表的研究,这些研究专注于美国的儿科人群,评估了基于种族或族裔背景的潜在差异,并专注于 CNS 肿瘤。使用标准化研究表格收集研究信息、感兴趣的人群、研究设计和分析质量、样本量、参与者人口统计学、评估的病理学以及观察到的发病率或结果。
共纳入 30 项研究。研究表明,白人儿童可能更有可能被诊断出患有 CNS 肿瘤,而西班牙裔儿童可能更有可能出现晚期疾病和更差的结局。社会经济因素的影响程度尚不清楚。本综述受到几个限制,包括少数将种族和族裔作为变量的可用研究、使用的数据库重叠以及种族和族裔的分类不明确。
本综述确定了 CNS 肿瘤儿童中种族/族裔差异的显著且有时相互矛盾的变化,表明这些差异的程度在很大程度上仍不清楚,并促使进一步研究以改善健康公平。