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Racial and ethnic disparities among children with primary central nervous system tumors in the US

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Abstract

Introduction

Primary central nervous system (CNS) tumors are among the most common and lethal types of cancer in children. However, the existence of health disparities in CNS tumors by race or ethnicity remains poorly understood. This systematic review sought to determine whether racial and ethnic disparities in incidence, healthcare access, and survival exist among pediatric patients diagnosed with CNS tumors.

Methods

A search of MEDLINE, Embase, CINAHL, Web of Science, and Scopus was conducted. Inclusion criteria selected for studies published between January 1, 2005 and July 15, 2020 that focused on pediatric populations in the US, evaluated for potential differences based on racial or ethnic backgrounds, and focused on CNS tumors. A standardized study form was used to collect study information, population of interest, research design, and quality of analysis, sample size, participant demographics, pathology evaluated, and incidence or outcomes observed.

Results

A total of 30 studies were inlcuded. Studies suggest White children may be more likely to be diagnosed with a CNS tumor and Hispanic children to present with advanced-stage disease and have worse outcomes. The degree of influence derived from socioeconomic factors is unclear. This review was limited by few available studies that included race and ethnicity as a variable, the overlap in databases used, and unclear categorization of race and ethnicity.

Conclusions

This review identified notable and at times contradicting variations in racial/ethnic disparities among children with CNS tumors, suggesting that the extent of these disparities remains largely unknown and prompts further research to improve health equity.

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Funding

BC was supported by a Medical Scientist Training Program grant from the National Institute of General Medical Sciences of the National Institutes of Health under award number T32GM007739 to the Weill Cornell/Rockefeller/Sloan Kettering Tri-Institutional MD–PhD Program.

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Author notes

  1. Edwin Nieblas-Bedolla and Briana Christophers have contributed equally to this work.

Authors and Affiliations

  1. University of Washington School of Medicine, Seattle, WA, USA

    Edwin Nieblas-Bedolla

  2. Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Edwin Nieblas-Bedolla

  3. Weill Cornell/Rockefeller/Sloan Kettering Tri-Institutional MD-PhD Program, New York, NY, USA

    Briana Christophers

  4. Department of Neurological Surgery, University of Washington, Seattle, WA, USA

    John R. Williams

  5. Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Alexandra Power-Hays

  6. Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA

    Nathalia Jimenez

  7. Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, WA, USA

    Nathalia Jimenez

  8. Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Analiz Rodriguez

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  1. Edwin Nieblas-Bedolla
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Contributions

ENB and BC conceptualized and designed, searched and extracted data, drafted the initial manuscript, and reviewed and revised the manuscript. JRW and AP drafted the initial manuscript, reviewed and revised the manuscript. NJ and AR provided guidance and critically reviewed the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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Correspondence to Edwin Nieblas-Bedolla.

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Nieblas-Bedolla, E., Christophers, B., Williams, J.R. et al. Racial and ethnic disparities among children with primary central nervous system tumors in the US. J Neurooncol 152, 451–466 (2021). https://doi.org/10.1007/s11060-021-03738-2

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