{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:30:10Z","timestamp":1792081810728,"version":"4.4.0"},"reference-count":33,"publisher":"Wiley","issue":"20","license":[{"start":{"date-parts":[[2018,8,20]],"date-time":"2018-08-20T00:00:00Z","timestamp":1534723200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"National Institutes of Health Translational Pediatric Cancer Epidemiology Training","award":["T32CA099936"],"award-info":[{"award-number":["T32CA099936"]}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2018,10,15]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>For many childhood cancers, survival is lower among non\u2010Hispanic blacks and Hispanics in comparison with non\u2010Hispanic whites, and this may be attributed to underlying socioeconomic factors. However, prior childhood cancer survival studies have not formally tested for mediation by socioeconomic status (SES). This study applied mediation methods to quantify the role of SES in racial\/ethnic differences in childhood cancer survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study used population\u2010based cancer survival data from the Surveillance, Epidemiology, and End Results 18 database for black, white, and Hispanic children who had been diagnosed at the ages of 0 to 19 years in 2000\u20102011 (n\u2009=\u200931,866). Black\u2010white and Hispanic\u2010white mortality hazard ratios and 95% confidence intervals, adjusted for age, sex, and stage at diagnosis, were estimated. The inverse odds weighting method was used to test for mediation by SES, which was measured with a validated census\u2010tract composite index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Whites had a significant survival advantage over blacks and Hispanics for several childhood cancers. SES significantly mediated the race\/ethnicity\u2013survival association for acute lymphoblastic leukemia, acute myeloid leukemia, neuroblastoma, and non\u2010Hodgkin lymphoma; SES reduced the original association between race\/ethnicity and survival by 44%, 28%, 49%, and 34%, respectively, for blacks versus whites and by 31%, 73%, 48%, and 28%, respectively, for Hispanics versus whites ((log hazard ratio total effect \u2013 log hazard ratio direct effect)\/log hazard ratio total effect).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SES significantly mediates racial\/ethnic childhood cancer survival disparities for several cancers. However, the proportion of the total race\/ethnicity\u2013survival association explained by SES varies between black\u2010white and Hispanic\u2010white comparisons for some cancers, and this suggests that mediation by other factors differs across groups.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.31560","type":"journal-article","created":{"date-parts":[[2018,8,20]],"date-time":"2018-08-20T05:14:13Z","timestamp":1534742053000},"page":"4090-4097","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":152,"title":["Does socioeconomic status account for racial and ethnic disparities in childhood cancer survival?"],"prefix":"10.1002","volume":"124","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6089-6799","authenticated-orcid":false,"given":"Rebecca D.","family":"Kehm","sequence":"first","affiliation":[{"name":"Division of Epidemiology and Community Health University of Minnesota School of Public Health  Minneapolis Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Logan G.","family":"Spector","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Clinical Research, Department of Pediatrics University of Minnesota  Minneapolis Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny N.","family":"Poynter","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Clinical Research, Department of Pediatrics University of Minnesota  Minneapolis Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Vock","sequence":"additional","affiliation":[{"name":"Division of Biostatistics University of Minnesota School of Public Health  Minneapolis Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean F.","family":"Altekruse","sequence":"additional","affiliation":[{"name":"National Cancer Institute  Bethesda Maryland"},{"name":"Epidemiology Branch, Prevention and Population Sciences Program, Division of Cardiovascular Sciences National Heart, Lung, and Blood Institute  Bethesda Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa L.","family":"Osypuk","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Community Health University of Minnesota School of Public Health  Minneapolis Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,8,20]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"SEER Cancer Statistics Review, 1975\u20102010","author":"Howlader N","year":"2013"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00008480-200402000-00004"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.canep.2015.06.009"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.25802"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10552-015-0609-1"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.3171\/2016.5.PEDS15704"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.29.6103"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.22825"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2015.02.007"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.23078"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0089482"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/ng1435"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.90.8.1212"},{"key":"e_1_2_8_15_1","volume-title":"SEER Program Coding and Staging Manual 2016","author":"Adamo M","year":"2016"},{"key":"e_1_2_8_16_1","unstructured":"Surveillance Epidemiology and End Results. 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