Socio-economic and ethnic disparities in childhood cancer survival, Yorkshire, UK
Menée au Royaume-Uni sur la période 1997-2001 à partir de données portant sur 2 674 patients pédiatriques atteints d'un cancer (âge : 0-14 ans), cette étude analyse les disparités ethniques et socio-économiques dans la survie
Résumé en anglais
Background: Establishing the existence of health inequalities remains a high research and policy agenda item in the United Kingdom. We describe ethnic and socio-economic differences in paediatric cancer survival, focusing specifically on the extent to which disparities have changed over a 20-year period.
Methods: Cancer registration data for 2674 children (0–14 years) in Yorkshire were analysed. Five-year survival estimates by ethnic group (south Asian/non-south Asian) and Townsend deprivation fifths (I–V) were compared over time (1997–2016) for leukaemia, lymphoma, central nervous system (CNS) and other solid tumours. Hazard ratios (HR: 95% CI) from adjusted Cox models quantified the joint effect of ethnicity and deprivation on mortality risk over time, framed through causal interpretation of the deprivation coefficient.
Results: Increasing deprivation was associated with significantly higher risk of death for children with leukaemia (1.11 (1.03–1.20)) and all cancers between 1997 and 2001. While we observed a trend towards reducing differences in survival over time in this group, a contrasting trend was observed for CNS tumours whereby sizeable variation in outcome remained for cases diagnosed until 2012. South Asian children with lymphoma had a 15% reduced chance of surviving at least 5 years compared to non-south Asian, across the study period.
Discussion: Even in the United Kingdom, with a universally accessible healthcare system, socio-economic and ethnic disparities in childhood cancer survival exist. Findings should inform where resources should be directed to provide all children with an equitable survival outcome following a cancer diagnosis.
