Black Race Associated with Worse HL Survival in Children, AYA

Among children, adolescents, and young adults with Hodgkin lymphoma (HL) enrolled in the New York State Medicaid Program, Black race/ethnicity was associated with inferior overall survival. This difference persisted even after adjustment for disease, demographic, and treatment data.

The study included 1,231 Medicaid-insured patients aged 1 to 39 diagnosed with classic HL from 2005 to 2015.

At a median follow-up of 6.6 years, 90% of patients were alive. The five-year overall survival was 92% in children younger than 15 years. The researchers used multivariable models adjusting for disease, demographic, and treatment data and found that Black patients had a 1.6-fold increased risk for death compared with White patients (hazard ratio [HR] = 1.58; 95% CI, 1.02 to 2.46;  P= 0.042).

Stage of disease was associated with greater risk of death. Stage III/IV disease was associated with a 1.9-fold increased risk compared with stage I/II (HR = 1.86; 95% CI. 125 to 2.78; P = 0.002).

In addition, patients treated at a non-National Cancer Institute affiliate was associated with worse disease-specific survival (HR = 2.71; 95% CI, 1.47 to 4.98; P=0.001).

“Further work is needed to identify dimensions of health care access not mediated by insurance, as findings suggest additional factors are contributing to observed cancer disparities invulnerable pediatric and AYA populations,” the researchers concluded.