Survival by race among children with extracranial solid tumors in the United States between 1985 and 2005

Background: The National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database was used to compare survival rates by race among children with common extracranial solid tumors between 1985 and 2005. Procedure: Diagnosis and outcome data were obtained from SEER. Five-year survival probabilities were calculated using the Kaplan-Meier method. Survival hazard ratios were calculated using the Cox proportional hazards model. Survival probabilities were compared among Whites, Blacks, American Indians/Alaskan Natives, and Asians/Pacific Islanders. Results: Five-year survival probabilities were higher for White children than for children belonging to other racial groups (77% vs. 71% for Blacks, 72% for American Indian/Alaskan Native, 72% for Asian/Pacific Islander). Male non-White children had worse 5-year survival than male White children while there were no differences in survival among females across racial groups. There was no difference when survival probabilities for Hispanic and non-Hispanic children were compared. Overall, Black children had a higher risk of death compared to White children (1.31, P < 0.05). Black children had a higher risk of death from germ cell tumors, hepatoblastoma and non-rhabdomyosarcoma soft tissue sarcomas. Asian/Pacific Islander children also had a higher risk of death overall (1.34, P < 0.05) and a higher risk of death from germ cell tumors, hepatocellular carcinoma, neuroblastoma, and Wilms tumor compared to White children. Conclusions: Male children from minority groups have poorer survival from extracranial solid malignancies than White male children. Future efforts should be directed at understanding the causes of these differences and at developing practical clinical interventions to eliminate them.