Abstract:
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Pediatric cancers exhibit marked variation in etiology, treatment response, and mortality. Cancer type is the main contributor of survival disparities followed by patient features such as race-ethnicity, sex, age, and geographic region. Cancer-specific studies of disparities have shown great utility in improving survival. However, public health policy focuses mainly on promoting well-being at the population level as such aggregated risk associated with patient factors across all cancers could better inform planning, surveillance, and resource allocation. Surveillance Epidemiology End Result (SEER) data provide estimates of aggregated mortality risk of all cancer sites, overall, and by patient factors, but this aggregation doesn’t account for unmeasured heterogeneity caused by extraneous factors including the wide variation in mortality of cancer types. This study used the frailty model on a SEER dateset of 101,328 pediatric cancer patients, diagnosed and followed between 1973-2016, to determine the aggregated race-ethnicity and sex disparities in pediatric survival across all cancer types after accounting for heterogeneity in mortality risk over cancer types and diagnosis years.
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