Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.
Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia.
Cancer Epidemiol Biomarkers Prev. 2022 Jun 1;31(6):1154-1158. doi: 10.1158/1055-9965.EPI-21-1068.
Racial/ethnic disparities in childhood cancer survival persist despite advances in cancer biology and treatment. Survival rates are consistently lower among non-Hispanic Black and Hispanic children as compared with non-Hispanic White children across a range of hematologic cancers and solid tumors. We provide a framework for considering complex systems and social determinants of health in research examining the drivers of racial/ethnic disparities in childhood cancer survival, given that pediatric patients' interactions with the healthcare system are filtered through their caregiver, family, and societal structure. Dismantling the multi-level (patient, family, healthcare system, and structural) barriers into modifiable drivers is critical to developing policies and interventions toward equitable health outcomes. This commentary highlights areas at the family, healthcare system, and society levels that merit closer examination and proposes actions and interventions to support improvements across these levels. See recently published article in the November issue of CEBP, Racial/Ethnic Disparities in Childhood Cancer Survival in the United States p. 2010.
尽管癌症生物学和治疗方面取得了进展，但儿童癌症存活率仍存在种族/民族差异。在一系列血液癌症和实体肿瘤中，与非西班牙裔白人和西班牙裔儿童相比，非西班牙裔黑人和西班牙裔儿童的存活率一直较低。鉴于儿科患者与医疗保健系统的互动是通过他们的照顾者、家庭和社会结构进行过滤的，我们为研究种族/民族差异对儿童癌症存活率的驱动因素提供了一个考虑复杂系统和健康社会决定因素的框架。将多层次（患者、家庭、医疗保健系统和结构）障碍分解为可修改的驱动因素对于制定实现公平健康结果的政策和干预措施至关重要。本评论强调了家庭、医疗保健系统和社会各级值得更仔细检查的领域，并提出了支持这些各级改进的行动和干预措施。请参阅最近在 11 月期《CEBP》上发表的文章，“美国儿童癌症存活率的种族/民族差异”，第 2010 页。
