Residing in border regions was linked with a higher risk of dying within five years among children with acute lymphoblastic leukemia, the most common type of pediatric cancer.
In an analysis of cancer registry data from Texas, children with acute lymphoblastic leukemia (ALL) who lived along the border with Mexico were more likely to die within five years than those living in other areas of the state. The findings are published by Wiley online in CANCER, a peer-reviewed journal of the American Cancer Society.
The United States-Mexico border has a mixture of rural and urban communities with populations living in these regions that are known to be medically underserved. Survival disparities have been observed here in adults diagnosed and treated for various malignancies, but information on pediatric cancer outcomes is lacking.
To investigate, Maria Castellanos, MD, currently of UCSF Benioff Children’s Hospitals, and her colleagues at Baylor College of Medicine and Texas Children’s Hospital conducted a retrospective survival analysis of children with the blood cancers ALL (the most common type of pediatric cancer) and acute myeloid leukemia (AML) whose information was listed in the Texas Cancer Registry. Between 1995 and 2017, there were 6,002 children diagnosed with ALL and 1,279 diagnosed with AML.
Among children with ALL, the proportion of children who survived for at least five years after diagnosis was lower in those living in border regions compared with those living in non-border areas (77.5% versus 85.8%). After adjusting for other factors known to impact survival such as age at diagnosis, sex, and socioeconomic status, children with ALL living along the border experienced a 30% higher risk of death compared with children living elsewhere in Texas. For children with AML, there was an increased risk of death only for those living in rural border counties.
“While there have been tremendous achievements in maximizing cure rates for children with leukemia in the United States, not everyone is benefiting from these advances. We know there are differences in survival, with children from historically marginalized Hispanic and Black communities faring worse than white children,” said Dr. Castellanos. “There is an urgent need to identify the reasons why these differences in survival are occurring, including an assessment of the barriers to obtaining health care and strategies to successfully reduce barriers.”
An accompanying editorial by Paula Aristizabal, MD, MAS, and colleagues from the University of California San Diego encourages officials to work to improve cancer outcomes in rural areas with concentrated poverty. “We urgently call for the attention of public health leaders and healthcare providers in both the U.S. and Mexico to mitigate the health disparities suffered by immigrants, a population that plays a vital role for the economies and social fabric of these two countries,” the authors write.
NOTE: The information contained in this release is protected by copyright. Please include journal attribution in all coverage. A free abstract of this article will be available via the CANCER Newsroom upon online publication. For more information or to obtain a PDF of any study, please contact: Sara Henning-Stout, [email protected]
“Ethnic disparities in childhood leukemia survival by border residence: A Texas population-based analysis.” Maria I. Castellanos, Abiodun O. Oluyomi, Tiffany M. Chambers, Maria M. Gramatges, Lena E. Winestone, Philip J. Lupo, and Michael E. Scheurer. CANCER; Published Online: February 21, 2023 (DOI: 10.1002/cncr.34636).
URL Upon Publication: http://doi.wiley.com/10.1002/cncr.34636
“At the border: A call to action for health equity for children with leukemia.” Paula Aristizabal, Courtney D. Thornburg, and Janine Young. CANCER; Published Online: February 21, 2023 (DOI: 10.1002/cncr.34629).
URL Upon Publication: http://doi.wiley.com/10.1002/cncr.34629
Author Contact: This research was conducted at Baylor College of Medicine. The contact information for Baylor College of Medicine’s communications office is Molly Chiu, at [email protected] Contact information for Dr. Castellanos’ home institution, UCSF, is Jamie Mondics at [email protected], and Vicky Agnew at [email protected]
About the Journal
CANCER is a peer-reviewed publication of the American Cancer Society integrating scientific information from worldwide sources for all oncologic specialties. The objective of CANCER is to provide an interdisciplinary forum for the exchange of information among oncologic disciplines concerned with the etiology, course, and treatment of human cancer. CANCER is published on behalf of the American Cancer Society by Wiley and can be accessed online. Follow us on Twitter @JournalCancer.
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Ethnic disparities in childhood leukemia survival by border residence: A Texas population-based analysis
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