Neuroblastoma: Devastating Disparities

Black, Asian, Native American children more likely to die from neuroblastoma than whites

(RxWiki News) After being treated for neuroblastoma, black, Asian, and Native American children are more likely to die than white and Hispanic children.

The finding arrives as part of a study looking at more than 3,500 patients with the disease, the largest-ever study of racial disparities in risk and survival for the most common solid cancer found in young children. The study also found that black and Native American children are more likely to have the high-risk form of the disease and show signs of resistance to modern treatment, both factors that may contribute to the higher mortality.

Neuroblastoma is a rare cancer, with only 650 new cases each year in the United States. Patients are generally categorized as having low-risk, intermediate-risk, or high-risk disease based on a number of clinical and biological factors.

The study looked at 3,500 children diagnosed between 2001 and 2009. This sample allowed a research group led by Cohn and Tara Henderson, MD, MPH, Assistant Professor of Pediatrics, to compare patients of different races on risk and survival. The results: 75 percent of white and Hispanic patients survived five years after diagnosis; 67 percent of black patients survived; 63 percent of Asian patients had survived; and 39 percent of Native American patients survived.
"By definition, if you are older and have advanced stage disease, you are at high risk for relapse and more difficult to cure," Cohn said. "The major reason why the black patients do worse is because there are more of them in this high-risk group."

Other disparities included the timing of post-treatment events such as cancer relapse or progression. Black patients with high-risk disease were significantly more likely to suffer a late-occurring event than white patients, suggesting black children are more likely to have residual cancer after therapy, according to Cohn.

"Disparities in outcome according to race do exist in neuroblastoma," said Susan Cohn, MD, professor of pediatrics at Comer Children's Hospital at the University of Chicago Medical Center and senior author of the study. "There are racial cohorts of patients who do more poorly than the white population."

Reviewed by: 
Review Date: 
November 23, 2010