Socioeconomic status and event free survival in pediatric acute lymphoblastic leukemia: a population-based cohort study

Sumit Gupta; Rinku Sutradhar; Astrid Guttmann; Lillian Sung; Jason D Pole

doi:10.1016/j.leukres.2014.08.017

Socioeconomic status and event free survival in pediatric acute lymphoblastic leukemia: a population-based cohort study

Leuk Res. 2014 Dec;38(12):1407-12. doi: 10.1016/j.leukres.2014.08.017. Epub 2014 Sep 1.

Authors

Sumit Gupta¹, Rinku Sutradhar², Astrid Guttmann³, Lillian Sung⁴, Jason D Pole⁵

Affiliations

¹ Division of Haematology/Oncology, Department of Paediatrics and Program in Child Health Evaluative Sciences, The Hospital for Sick Children, 555 University Avenue, Toronto, Canada M5G 1X8. Electronic address: [email protected].
² Institute for Clinical Evaluative Sciences, G1 06, 2075 Bayview Avenue, Toronto, Canada M4N 3M5; Dalla Lana School of Public Health, University of Toronto, 6th floor, 155 College Street, Toronto, Canada M5T 3M7.
³ Institute for Clinical Evaluative Sciences, G1 06, 2075 Bayview Avenue, Toronto, Canada M4N 3M5; Division of Paediatric Medicine, Department of Paediatrics, Hospital for Sick Children, 555 University Avenue, Toronto, Canada M5G 1X8; Institute of Health Policy, Management and Evaluation, University of Toronto, Suite 425, 155 College Street, Toronto, Canada M5T 3M6.
⁴ Division of Haematology/Oncology, Department of Paediatrics and Program in Child Health Evaluative Sciences, The Hospital for Sick Children, 555 University Avenue, Toronto, Canada M5G 1X8; Institute of Health Policy, Management and Evaluation, University of Toronto, Suite 425, 155 College Street, Toronto, Canada M5T 3M6.
⁵ Pediatric Oncology Group of Ontario, Suite 1014, 480 University Avenue, Toronto, Canada M5G 1V2.

PMID: 25224660
DOI: 10.1016/j.leukres.2014.08.017

Abstract

The impact of socioeconomic status (SES) upon childhood cancer outcomes has not been extensively examined. Our objective was to determine the association between SES and event-free survival (EFS) among children with acute lymphoblastic leukemia (ALL) diagnosed in Ontario, Canada from 1995-2011 (N=1541) using Cox proportional hazards. Neither neighborhood-level median income quintile, distance from tertiary center, or rural residence significantly predicted EFS in the context of a universal healthcare system. Immigrant children experienced significantly superior EFS; confounding by ethnicity could not be ruled out. Confirmatory studies using additional individual-level SES variables are warranted.

Keywords: Acute lymphoblastic leukemia; Cancer; Child; Disparities; Immigrant; Socioeconomic status.

Publication types

Clinical Trial
Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Child
Child, Preschool
Disease-Free Survival
Female
Humans
Infant
Male
Ontario / epidemiology
Precursor Cell Lymphoblastic Leukemia-Lymphoma / mortality*
Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy
Rural Population*
Socioeconomic Factors
Survival Rate
Tertiary Care Centers*