Researchers from the University of Colorado Cancer Center have made strides in understanding the reasons behind disparities in outcomes for cancer patients of different races. Focusing particularly on pediatric brain cancer patients, the investigators confirmed that Black and Hispanic children with brain cancer have worse outcomes than non-Hispanic white children. These findings, which follow similar trends for adults, are unique in their attempts to explain where the breakdowns in the diagnosis and treatment processes occur. They were published recently in the journal Scientific Reports.
The study analyzed cases of pediatric brain cancer cases at Children's Hospital Colorado. Looking at 1,881 patients under 19 years old with brain and central nervous system cancer diagnoses from 2000-2015, 52% of White patients lived five years from diagnosis, compared to 44% of African American patients and 45% of Hispanic patients.
"If we look overall in the pediatric brain and central nervous system cancers, Black and Hispanic patients have a higher risk of dying from these tumors compared with non-Hispanic White patients," stated the study's senior author, Adam Green, MD, CU Cancer Center investigator and pediatric brain cancer specialist at Children's Hospital Colorado. "Even when they presented with similar stage disease as their White counterparts, they still did worse."
They found that there were no disparities among race at the time of diagnosis, rather than Black and Hispanic patients had poorer outcomes than non-Hispanic White patients during treatment and follow-up care.
"We were surprised," says Green. "In general, we expect these disparities to be multi-factorial and have pre- and post-diagnosis components, but these findings suggest these patients are able to get diagnosed appropriately, but after that, treatment and follow up may be where the disparities lie."
The researchers say that understanding the inequality and inequity of the healthcare system is crucial to contextualizing patients’ outcomes and developing improved planning mechanisms. "One thing we don't talk about enough in cancer is how much of a burden going through treatment is on families - financial resources, transportation resources, time resources, shelter and lodging resources, etc.," Green says. "We can plan an effective treatment, but if there are life factors that make it more challenging for some families to get that entire course of treatment successfully, then all the planning we do isn't going to make the treatment as effective as we would like it to be. It's incumbent on us to make sure these families have access to the resources they need to ensure that their children are able to get the highest quality care."