{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T15:31:41Z","timestamp":1787671901534,"version":"build-2736575974"},"reference-count":39,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100001445","name":"Alex's Lemonade Stand Foundation for Childhood Cancer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001445","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp;amp; Cancer"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Germ cell tumors (GCTs) often arise in the ovaries and testes (extracranial) but can also develop in the brain (intracranial). We examined the relationship of individual, family, and community\u2010level socioeconomic status (SES) with stage of disease at diagnosis in a cohort of pediatric patients with GCT from Children's Oncology Group (COG) registries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We obtained COG data from participants enrolled in 2003\u20132021, including summary stage (operationalized as local, regional, distant for extracranial tumors, and as early vs. late stages for intracranial tumors), tumor subtype, demographics, and ZIP code at diagnosis. We linked ZIP codes to county\u2010level redlining scores (C,D = greatest redlining), Child Opportunity Index (COI), and racial dissimilarity indices. Logistic regressions calculated odds ratios (ORs) and 95% confidence intervals (CIs) for late\u2010stage diagnosis; sex\u2010stratified models were also fit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 1850 patients with GCT,\n                      <jats:italic>n<\/jats:italic>\n                      = 1316 had extracranial and\n                      <jats:italic>n<\/jats:italic>\n                      = 534 intracranial tumors. In multivariable models, females had lower odds of distant stage disease diagnosis (extracranial: OR, 0.40; 95% CI, 0.28\u20130.58 vs. local\/regional; intracranial OR, 0.44; 95% CI, 0.24\u20130.83) than males. Participants diagnosed between 1998\u20132009 (OR, 0.52; 95% CI, 0.29\u20130.68) and 2010\u20132014 (OR, 0.51; 95% CI, 0.39\u20130.68) had lower odds of local stage disease than regional or distant stage disease versus 2015\u20132021. For males, residence in a micropolitan residence was associated with lower odds of regional\/distant\/late\u2010stage disease (OR, 0.55; 95% CI, 0.31\u20130.95) while being uninsured was associated with higher odds of late\u2010stage disease (OR, 1.81; 95% CI, 1.16\u20132.81). No family\/area factors were significant for females.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Individual SES factors potentially explain more stages of disease disparities than area\u2010level factors for young patients with GCT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/1545-5017.70562","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T13:33:37Z","timestamp":1785850417000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sociodemographic Factors Associated With Later Stage at Diagnosis of Pediatric Germ Cell Tumors: A Report From Children's Oncology Group Registries ACCRN07 and APEC14B1"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8466-7659","authenticated-orcid":false,"given":"Heydon K.","family":"Kaddas","sequence":"first","affiliation":[{"name":"Cancer Control and Population Sciences Huntsman Cancer Institute, University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judy Y.","family":"Ou","sequence":"additional","affiliation":[{"name":"Cancer Control and Population Sciences Huntsman Cancer Institute, University of Utah  Salt Lake City Utah USA"},{"name":"DLH Corporation Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd","family":"Alonzo","sequence":"additional","affiliation":[{"name":"Children's Oncology Group  Philadelphia Pennsylvania USA"},{"name":"Research Population and Public Health Sciences Keck School of Medicine, University of Southern California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Logan G.","family":"Spector","sequence":"additional","affiliation":[{"name":"University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Negar","family":"Fallahazad","sequence":"additional","affiliation":[{"name":"Children's Oncology Group  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Owens","sequence":"additional","affiliation":[{"name":"Hamilton Holt School Rollins College  Winter Park Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0747-9179","authenticated-orcid":false,"given":"Anne C.","family":"Kirchhoff","sequence":"additional","affiliation":[{"name":"Cancer Control and Population Sciences Huntsman Cancer Institute, University of Utah  Salt Lake City Utah USA"},{"name":"Department of Pediatrics University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam L.","family":"Green","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Colorado School of Medicine  Aurora Colorado USA"},{"name":"Center for Cancer and Blood Disorders Children's Hospital Colorado  Aurora Colorado 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