Published: 05/01/16
Little is known about the survivorship experience of black and Hispanic childhood cancer survivors. How does it compare with that of non-Hispanic white survivors? Thanks to the large number of participants in the LTFU Study, a team led by Dr. Qi Liu of the University of Alberta was able to provide some answers.
The research team looked at information provided by members of the original study cohort, who were diagnosed between 1970 and 1986. Of the 14,358 childhood cancer survivors who completed the LTFU Study baseline questionnaire, 13,841 provided information on race/ethnicity and were included in the study results. The analysis included information from 750 Hispanic and 694 non-Hispanic black participants — not big numbers but enough to ensure valid conclusions.
The team looked at participants’ experience of premature mortality, second cancers and chronic health conditions like heart disease and diabetes. Overall the Hispanic and non-Hispanic black participants tended to have lower incomes and education levels compared to the non-Hispanic whites, and study results showed that these factors were linked to a higher risk of premature death. However, the extra risk did not exist when comparing Hispanic and non-Hispanic blacks to non-Hispanic whites who had similar income and education levels.
Like other African-Americans in the U.S., the non-Hispanic black participants in this study were more likely to have high blood pressure. High blood pressure is a risk factor for heart disease, and having high blood pressure increased the chances of developing heart disease for non-Hispanic blacks compared to other survivors in the study.
Additionally, Hispanic and non-Hispanic participants tended to be more overweight or obese. Both groups were more likely to develop diabetes compared to non-Hispanic white participants, even when comparing individuals who were similar in weight, income, and education. This unexplained increase in diabetes risk is an important finding that needs additional study.
There were no cases of non-melanoma skin cancer among the non-Hispanic black survivors who received radiation and the skin cancer risk was lower for Hispanics than for non-Hispanic whites.
Despite these individual differences, the team found that treatment exposures had no effect on racial/ethnic differences in risk of premature mortality, second cancers or chronic health conditions. The differences among the groups were accounted for by survivors’ individual traits.
This study fills an important gap in our understanding of the long-term prospects of survivors who belong to racial and ethnic minorities. Thanks to all of our study participants we can bring you the good news that cancer treatments don’t come with extra risks for Hispanic and non-Hispanic black children.
We especially want to thank our Hispanic and non-Hispanic black participants for making this research possible. We’re grateful for your ongoing dedication and support!
Liu Q, Leisenring WM, Ness KK, et al. Racial/Ethnic Differences in Adverse Outcomes Among Childhood Cancer Survivors: The Childhood Cancer Survivor Study. J Clin Oncol 2016 34(14):1634-43.