title: Childhood cancer survivorship research in minority populations: A position paper from the Childhood Cancer Survivor Study.
abstract: By the middle of this century, racial/ethnic minority populations will collectively constitute 50% of the US population. This temporal shift in the racial/ethnic composition of the US population demands a close look at the race/ethnicity-specific burden of morbidity and premature mortality among survivors of childhood cancer. To optimize targeted long-term follow-up care, it is essential to understand whether the burden of morbidity borne by survivors of childhood cancer differs by race/ethnicity. This is challenging because the number of minority participants is often limited in current childhood cancer survivorship research, resulting in a paucity of race/ethnicity-specific recommendations and/or interventions. Although the overall childhood cancer incidence increased between 1973 and 2003, the mortality rate declined; however, these changes did not differ appreciably by race/ethnicity. The authors speculated that any racial/ethnic differences in outcome are likely to be multifactorial, and drew on data from the Childhood Cancer Survivor Study to illustrate the various contributors (socioeconomic characteristics, health behaviors, and comorbidities) that could explain any observed differences in key treatment-related complications. Finally, the authors outlined challenges in conducting race/ethnicity-specific childhood cancer survivorship research, demonstrating that there are limited absolute numbers of children who are diagnosed and survive cancer in any one racial/ethnic minority population, thereby precluding a rigorous evaluation of adverse events among specific primary cancer diagnoses and treatment exposure groups. Cancer 2016;122:2426-2439. © 2016 American Cancer Society.
authors.affiliation: Institute for Cancer Outcomes and Survivorship, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Smita
authors.initials: S
authors.lastname: Bhatia
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: Todd M
authors.initials: TM
authors.lastname: Gibson
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: Kirsten K
authors.initials: KK
authors.lastname: Ness
authors.affiliation: School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Qi
authors.initials: Q
authors.lastname: Liu
authors.affiliation: Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York.|Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Oeffinger
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Krull
authors.affiliation: Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Paul C
authors.initials: PC
authors.lastname: Nathan
authors.affiliation: Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Neglia
authors.affiliation: Cancer Prevention and Clinical Statistics Programs, Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors.forename: Wendy
authors.initials: W
authors.lastname: Leisenring
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.|School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yasui
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: Leslie L
authors.initials: LL
authors.lastname: Robison
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: Gregory T
authors.initials: GT
authors.lastname: Armstrong
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D015438:Health Behavior; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008913:Minority Groups / Q000706:statistics & numerical data*; D009026:Mortality; D009369:Neoplasms / Q000453:epidemiology / Q000401:mortality*; D010342:Patient Acceptance of Health Care; D011159:Population Surveillance; D012309:Risk-Taking; D017741:Survivors; D014481:United States / Q000453:epidemiology / Q000208:ethnology
keywords: cancer burden; childhood cancer; minorities; population trends; survivorship