title: The impact of age and race on longevity in pediatric astrocytic tumors: A population-based study.
abstract: OBJECTIVE
  Despite improvements in pediatric brain tumor outcomes, the survivors of childhood brain tumor are burdened by multiple comorbidities. This work reports on the relative survival ratios and excess mortality rate in children with astrocytic tumors over the past four decades.
  
  
  METHODS
  Survival analysis was conducted using flexible parametric model to estimate relative survival and excess mortality rate for non-white and white children (0-19 years old) using the Surveillance, Epidemiology & End Results (SEER) database. We incorporated age group and year of diagnosis into the model to estimate these indices for the period of 1973-2010.
  
  
  RESULTS
  Progressive decline in relative survival ratios was noted over time. Non-white children had lower survival rates than white children, and these survival patterns persisted over the four-decade span of the study. Fifty percent of non-white survivors were deceased 30 years post diagnosis, compared to 35 years in white survivors.
  
  
  CONCLUSIONS
  Survivors of childhood brain tumors have progressively lower survival rates as they get older, and this is higher in non-white when compared to white children. Future research efforts need to focus on understanding the factors mediating the effect of the tumor or its treatment on survival in these patients, and the ethnic variations that derive these survival trends.
authors: Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.|Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada.
authors: M Constantine
authors: MC
authors: Samaan
authors: School of Nursing, McMaster University, Hamilton, Ontario, Canada.|Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada.
authors: Noori
authors: N
authors: Akhtar-Danesh
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001254:Astrocytoma / Q000401:mortality* / Q000628:therapy; D002423:Cause of Death; D016543:Central Nervous System Neoplasms / Q000401:mortality* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008136:Longevity; D008297:Male; D044469:Racial Groups / Q000706:statistics & numerical data*; D018426:SEER Program; D015996:Survival Rate; D017741:Survivors / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
keywords: SEER; brain tumors; longevity; relative survival analysis; survivorship