Distance to treatment center and other non-medical factors that can influence pediatric cancer survival

Abstract

BACKGROUND: A major component in determining the prognosis for all pediatric cancers is the biology of specific malignancies. However, it has also been found that non-medical factors such as distance between home and treatment center, rural versus urban residence, and socioeconomic status can influence pediatric cancer survival. Relatively few studies have been done in this area. AIMS: This study attempted to evaluate whether there are disparities in pediatric cancer survival outcomes in North Carolina (NC) based on geography. Other demographic characteristics of the patients were also examined, including race, ethnicity, sex, and county of residence. METHODS: A retrospective, single-institution study at the University of North Carolina (UNC) Hospital was performed using a clinical database. Eligibility was limited to patients 0-21 years of age who were diagnosed with acute myeloid leukemia, acute lymphoblastic leukemia, central nervous system tumors, neuroblastoma, rhabdomyosarcoma, or Wilms tumor between the years 2000 and 2018 who were NC residents and treated at UNC Hospital. RESULTS: Distance to the UNC Hospital from a patient’s residence did not have a statistically significant impact on pediatric cancer survival outcomes. However, patients living in non-metropolitan areas had lower survival outcomes when compared to patients residing in metropolitan regions. Patients who were African Americans and “Other” races had lower survival outcomes when compared to Whites. CONCLUSIONS: Although this study indicates no significant association between distance to the UNC Hospital and pediatric cancer survival outcome, patient race and metropolitan classification of a patient’s county of residence appear to be linked with survival disparities.