Pediatric glioma and medulloblastoma risk and population demographics: a Poisson regression analysis

Author:

Muskens Ivo S1ORCID,Feng Qianxi1,Francis Stephen S2,Walsh Kyle M3,Mckean-Cowdin Roberta1,Gauderman William J4,de Smith Adam J1,Wiemels Joseph L1

Affiliation:

1. Department of Preventive Medicine, Center for Genetic Epidemiology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA

2. Department of Neurosurgery, Division of Neuro and Molecular Epidemiology, University of California, San Francisco, California, USA

3. Department of Neurosurgery, Duke Cancer Institute, and Children’s Health and Discovery Institute, Duke University, Durham, North Carolina, USA

4. Division of Biostatistics, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA

Abstract

Abstract Background The incidence of pediatric brain tumors varies by race and ethnicity, but these relationships may be confounded by socioeconomic status (SES). In this study, the Surveillance, Epidemiology, and End Results Program (SEER) database was evaluated for associations between race/ethnicity and pediatric glioma and medulloblastoma risk with adjustment for SES. Methods Pediatric glioma and medulloblastoma cases from the SEER database (years: 2000–2016) were included. Differences in incidence rates by ethnicity, sex, age, and SES-related factors were evaluated by calculation of age-adjusted incidence rates (AAIRs) and annual percent change (APC). SES-related factors (percentage without less than high school graduation, median household income, and percentage foreign-born) were derived from the census at the county-level (year: 2000). Multivariable Poisson regression models with adjustment for selected covariates were constructed to evaluate risk factors. Results The highest AAIRs of pediatric glioma were observed among non-Hispanic Whites (AAIR: 2.91 per 100 000, 95%-CI: 2.84–2.99). An increasing incidence of pediatric glioma by calendar time was observed among non-Hispanic Whites and non-Hispanic Blacks (APC: 0.97%, 95%-CI: 0.28–1.68 and APC: 1.59%, 95%-CI: 0.03–3.18, respectively). Hispanic and non-Hispanic Black race/ethnicity was associated with lower risk when compared with non-Hispanic White (incidence rate ratios [IRRs]: 0.66, 95%-CI: 0.63–0.70; and 0.69, 95%-CI: 0.65–0.74, respectively). For medulloblastoma, the highest AAIR was observed for non-Hispanic Whites with a positive APC (1.52%, 95%-CI: 0.15–2.91). Hispanics and non-Hispanic Blacks had statistically significant lower IRRs compared with non-Hispanic Whites (IRRs: 0.83, 95%-CI: 0.73–0.94; and 0.72, 95%-CI: 0.59–0.87, respectively). Conclusion Non-Hispanic White race/ethnicity was associated with higher pediatric glioma and medulloblastoma IRRs in models with adjustments for SES.

Funder

National Institutes of Health

Sontag Foundation

Publisher

Oxford University Press (OUP)

Subject

Electrical and Electronic Engineering,Building and Construction

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