title: Racial and ethnic disparities in survival of US children with acute lymphoblastic leukemia: evidence from the SEER database 1988-2008.
abstract: OBJECTIVE
  Prior studies have shown poorer survival from childhood acute lymphoblastic leukemia (ALL) among some minorities compared to non-Hispanic whites (NHW). Here, we examine whether these survival disparities have persisted and to see whether they also exist for Asian and Hispanic subgroups.
  
  
  METHODS
  Using data from the US National Cancer Institute's Surveillance, Epidemiology and End Results program from 1988 to 2008, we compared all natural-cause survival for children aged 19 years or under diagnosed with ALL using Cox proportional hazards models adjusted for age, diagnosis year, gender and disease immunophenotype.
  
  
  RESULTS
  Black, Hispanic and Native American children continue to have significantly poorer survival than NHW. Unlike previous studies, we found that Asian Americans also had significantly worse survival. Among Asian subgroups, Vietnamese (relative risk [RR] = 2.44, 95 % CI = 1.50-3.97) and Filipinos (RR = 1.64, 95 % CI = (1.13-2.38) had significantly poorer survival, while other East Asian groups, except Chinese, had non-significantly worse survival. Most Hispanic subgroups had RRs around 2.
  
  
  CONCLUSIONS
  Previously observed poorer prognosis for childhood ALL for some minority groups appears to be shared by most Asians as well. Further research is needed to find explanations for the poorer survival of minority children with ALL and possible treatment implications.
authors.affiliation: Department of Psychology, Chinese University of Hong Kong, Shatin, Hong Kong. wgoggins@cuhk.edu.hk
authors.forename: William B
authors.initials: WB
authors.lastname: Goggins
authors.forename: Fiona F K
authors.initials: FF
authors.lastname: Lo
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D007223:Infant; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000453:epidemiology / Q000208:ethnology* / Q000235:genetics / Q000401:mortality*; D044469:Racial Groups / Q000706:statistics & numerical data; D012042:Registries; D012189:Retrospective Studies; D018426:SEER Program; D015996:Survival Rate; D014481:United States / Q000453:epidemiology; D055815:Young Adult