title: Treatment outcomes in black and white children with cancer: results from the SEER database and St Jude Children's Research Hospital, 1992 through 2007.
abstract: OBJECTIVE
  Treatment outcome for black patients with cancer has been significantly worse than for their white counterparts. We determined whether recent improved treatment had narrowed the gap in outcome between black and white pediatric patients.
  
  
  METHODS
  In a parallel comparison, we analyzed survival by disease category between black and white patients with childhood cancer registered in one of the 17 cancer registries of the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program or treated at St Jude Children's Research Hospital, which provides comprehensive treatment to all patients regardless of their ability to pay, from 1992 to 2000 and from 2001 to 2007.
  
  
  RESULTS
  Analysis of the SEER data indicated that in both study periods, black patients had significantly poorer rates of survival than did white patients, with the exception of a few types of cancer. Despite significantly improved treatment outcomes for patients who were treated from 2001 to 2007, the racial difference in survival has actually widened for acute myeloid leukemia and neuroblastoma. By contrast, in the cohorts treated at St Jude Children's Research Hospital, there were no significant differences in survival between black and white patients in either study period, regardless of the cancer type. Importantly, the outcome of treatment for acute lymphoblastic leukemia, acute myeloid leukemia, and retinoblastoma has improved in parallel for both races during the most recent study period.
  
  
  CONCLUSIONS
  With equal access to comprehensive treatment, black and white children with cancer can achieve the same high cure rates.
authors.affiliation: St Jude Children's Research Hospital, Memphis, TN 38105, USA. ching-hon.pui@stjude.org
authors.forename: Ching-Hon
authors.initials: CH
authors.lastname: Pui
authors.forename: Deqing
authors.initials: D
authors.lastname: Pei
authors.forename: Alberto S
authors.initials: AS
authors.lastname: Pappo
authors.forename: Scott C
authors.initials: SC
authors.lastname: Howard
authors.forename: Cheng
authors.initials: C
authors.lastname: Cheng
authors.forename: John T
authors.initials: JT
authors.lastname: Sandlund
authors.forename: Wayne L
authors.initials: WL
authors.lastname: Furman
authors.forename: Raul C
authors.initials: RC
authors.lastname: Ribeiro
authors.forename: Sheri L
authors.initials: SL
authors.lastname: Spunt
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Rubnitz
authors.forename: Sima
authors.initials: S
authors.lastname: Jeha
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Hudson
authors.forename: Larry E
authors.initials: LE
authors.lastname: Kun
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Merchant
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kocak
authors.forename: Alberto
authors.initials: A
authors.lastname: Broniscer
authors.forename: Monika L
authors.initials: ML
authors.lastname: Metzger
authors.forename: James R
authors.initials: JR
authors.lastname: Downing
authors.forename: Wing
authors.initials: W
authors.lastname: Leung
authors.forename: William E
authors.initials: WE
authors.lastname: Evans
authors.forename: Amar
authors.initials: A
authors.lastname: Gajjar
mesh_terms: D001741:Black or African American; D002648:Child; D002675:Child, Preschool; D006801:Humans; D009369:Neoplasms / Q000208:ethnology* / Q000401:mortality* / Q000628:therapy; D018426:SEER Program; D016019:Survival Analysis; D016896:Treatment Outcome; D044465:White People