title: Socioeconomic status and event free survival in pediatric acute lymphoblastic leukemia: a population-based cohort study.
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.
authors.affiliation: 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: sumit.gupta@sickkids.ca.
authors.forename: Sumit
authors.initials: S
authors.lastname: Gupta
authors.affiliation: 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.
authors.forename: Rinku
authors.initials: R
authors.lastname: Sutradhar
authors.affiliation: 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.
authors.forename: Astrid
authors.initials: A
authors.lastname: Guttmann
authors.affiliation: 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.
authors.forename: Lillian
authors.initials: L
authors.lastname: Sung
authors.affiliation: Pediatric Oncology Group of Ontario, Suite 1014, 480 University Avenue, Toronto, Canada M5G 1V2.
authors.forename: Jason D
authors.initials: JD
authors.lastname: Pole
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009864:Ontario / Q000453:epidemiology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000401:mortality* / Q000628:therapy; D012424:Rural Population; D012959:Socioeconomic Factors; D015996:Survival Rate; D062606:Tertiary Care Centers
keywords: Acute lymphoblastic leukemia; Cancer; Child; Disparities; Immigrant; Socioeconomic status