Looking at Eye Cancer in Kids

Retinoblastoma often diagnosed and treated later in minority and uninsured children

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Cancer of the eye is very rare. It strikes mostly infants and young children—about 350 kids a year in the US. The disease is curable when caught and treated early. If the cancer spreads, though, the outlook is not as good.

A new study has found that retinoblastoma (eye cancer) may be more invasive when it’s diagnosed in uninsured and minority children.

The authors suggested the outlook for these children is worse, usually because of a delay in diagnosis.

"If your baby’s eyes look strange, visit a pediatrician."

Researchers at Dana-Farber/Children's Hospital Cancer Center (DF/CHCC) reviewed the patient records of 203 children from around the US who had been treated for retinoblastoma. Adam Green, MD, of DF/CHCC, was the lead author.

Retinoblastoma affects the child’s retina where tumors form. Treatment usually involves removal of the diseased eye. If the cancer has spread, chemotherapy may be given after the surgery.

"The longer that retinoblastomas grow before they're diagnosed and treated, the more invasive they become," Dr. Green said in a statement. "In this study, we used tumor invasiveness as an indicator of delays in disease diagnosis."

Children in the study participated in a clinical trial by the Children's Oncology Group, a consortium of more than 8,000 childhood cancer experts on three continents.

Youngsters in the study had all had surgery and chemotherapy as needed.

The researchers gathered information on patients' race, ethnicity and insurance status. Collected tumor tissue was examined by pathologists.

The study sought to learn if non-white, Hispanic and uninsured youngsters were diagnosed with metastatic (has spread) disease that required chemotherapy.

Hispanic children were found to be the most likely to be diagnosed with invasive disease. The authors surmised that not speaking English may have been a barrier to receiving a prompt diagnosis and treatment.

“Race, ethnicity, and insurance status all correlated with high-risk pathologic features in a large group of retinoblastoma patients who had central pathologic review,” the authors wrote.

“Further inquiry should focus on studying the impact of primary language directly, as well as on where, specifically, in the diagnostic process delays exist, so that interventions can focus on overcoming barriers to care for these groups,” the authors concluded.

Senior author, Carlos Rodriguez-Galindo, MD, of DF/CHCC, said, "Is it because patients' families aren't familiar with the warning signs of the disease, because they have trouble getting to a primary care doctor or ophthalmologist for an exam, or some other factor? We hope to explore those questions in future studies."

Findings from this study are being presented at the 26th annual meeting of the American Society of Pediatric Hematology Oncology.

All research is considered preliminary before it's published in a peer-reviewed journal.

Reviewed by: 
Review Date: 
April 25, 2013
Last Updated:
August 14, 2013