Outcome of treatment for childhood cancer in black as compared with white children: the St Jude Children's Research Hospital experience, 1962 through 1992

Black children and white, Hispanic, and Asian children with cancer who have equal access to contemporary therapy appear to have similar survival rates. Researchers compared the survival rates in 798 black children with various forms of cancer with the rates in 4,507 white, Hispanic, and Asian children with various cancers. The patients were treated between January, 1962 and June, 1992 regardless of their families' ability to pay. Among the children who received care before the advent of major treatment advances, the overall 10-year cancer survival rate was 37% in black children and 50% in the other children. Among the children who were treated after the advent of major therapeutic advances, the 10-year survival rate was 67% in blacks and 66% in the others. The improved treatment outcome observed in black children is largely due to a higher survival rate in those with acute lymphoblastic leukemia.
Objective.--To determine whether there is a racial difference in prognosis among childhood cancers. Design.--An overall (30-year) survival analysis by race was followed by separate studies for "early" and "recent" treatment eras, defined by time points at which significantly improved outcome was demonstrated for specific tumor types. Stratified analyses were performed to adjust for recognized prognostic features. Setting.--Pediatric oncology research and treatment center. Patients.--The study included 798 black and 4507 white children with newly diagnosed malignancies treated from January 1962 through June 1992. These patients were accepted for treatment regardless of their financial status and were enrolled on disease-specific protocols. Results.--Across the 30-year study period, black children had a significantly poorer rate of survival than white children (P