Ethnic, Racial & Socioeconomic Disparities in Retinoblastoma in Children

Retinoblastoma can show up easily in a photo taken with a flash

Retinoblastoma can show up easily in a photo taken with a flash

Ethnic, racial and socioeconomic disparities appear to exist among children with retinoblastoma, a once uniformly fatal but now treatable eye cancer, and those disparities are associated with greater risks for advanced disease and undergoing enucleation (removal of the eye), according to an article published online by JAMA Pediatrics.

Retinoblastoma is a rare childhood cancer with about 9,000 cases diagnosed yearly worldwide. When diagnosed early, salvaging the eye and preserving vision are possible with relatively minimal therapy. Although disparities in access to health care have been well discussed for adult cancers, little is known about pediatric cancers.

Carlos Rodriguez-Galindo, M.D., of the Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Boston, and coauthors reviewed 18 Surveillance, Epidemiology and End Results (SEER) registries from 2000 through 2010. The authors identified 830 cases of retinoblastoma for children up to 9 years old and examined the effects of socioeconomic status, race and ethnicity on the extent of disease and outcomes.

Among the 830 children, Hispanic children had a higher percentage of extraocular (outside of the eye or advanced disease) compared with non-Hispanic children 33 percent (86 of 261) vs. 20 percent (102 of 510). Among 771 children whose extent of disease could be determined, 188 (24.4 percent) of them presented with extraocular disease. The percentage of extraocular cases was higher in counties with low socioeconomic status indicators including higher poverty, lower educational attainment, higher levels of crowding, higher unemployment, higher language isolation and higher percentage of immigrants, according to the results.

Ocular outcomes were known for 822 children and 574 of these children (69.8 percent) underwent enucleation at some point in treatment. Hispanic children were 41 percent more likely to undergo enucleation than non-Hispanic white children, according to the study. The percentage of enucleation was higher among Hispanic compared with non-Hispanic children 74.5 percent (202 of 271) vs. 67.5 percent (372 of 551). Higher rates of enucleation also were associated with low educational attainment and a higher level of crowding.

The five-year relative survival rate was 97.7 percent.

The authors acknowledge limitations inherent to the use of SEER registry and census data and to extrapolating indicators to investigate social determinants of health in this specific population.

“Low socioeconomic status affects disease extent and ocular outcomes, presumably by limiting access to primary and cancer-directed care,” the study notes.

Source: MNT



About LFCT

This is a blog about CHILDHOOD CANCER and CHILDHOOD CANCER AWARENESS Little Fighters Cancer Trust is a non-profit organisation that offers support and aid to Children with Cancer and their families. When a child is diagnosed with cancer it affects the whole family. One of the parents, usually the mother, must give up their job to care for the child and this creates financial problems for the family. In South Africa especially the majority of these families are not well-to-do; many of them are rural. A diagnosis of cancer can wipe out any family’s finances, let alone a poor family. The costs of special medications, special diets, hospital stays, transport to and from the hospital or clinic and accommodation and food costs for the mother who spends most of the time at her child’s bedside are astronomical. These are the people and problems that fall through the cracks, and these are the people that Little Fighters Cancer Trust has pledged to help in any way possible. LFCT takes a holistic approach to assisting the Children with Cancer and their Families, with the main aim to be the preservation of individual dignity and pride. Little Fighters Cancer Trust also focuses on promotion and advocacy of National Childhood Cancer Awareness in an effort to increase awareness of Early Warning Signs of Childhood Cancer. This would result in earlier diagnosis, giving the Child with Cancer more of a chance at Treatment and Survival. See "About" for more Background info

Posted on 10 October, 2015, in Blog, Research and tagged , , , , . Bookmark the permalink. Leave a comment.

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