OUTCOME OF TREATMENT FOR CHILDHOOD-CANCER IN BLACK AS COMPARED WITH WHITE-CHILDREN - THE ST-JUDE-CHILDRENS-RESEARCH-HOSPITAL EXPERIENCE, 1962 THROUGH 1992

Objective.-To determine whether there is a racial difference in progno sis among childhood cancers. Design.-An overall (30-year) survival ana lysis by race was followed by separate studies for ''early'' and ''rec ent'' treatment eras, defined by time points at which significantly im proved outcome was demonstrated for specific tumor types, Stratified a nalyses were performed to adjust for recognized prognostic features. S etting.-Pediatric oncology research and treatment center. Patients.-Th e study included 798 black and 4507 white children with newly diagnose d malignancies treated from January 1962 through June 1992. These pati ents were accepted for treatment regardless of their financial status and were enrolled on disease-specific protocols. Results.-Across the 3 0-year study period, black children had a significantly poorer rate of survival than white children (P<.,001, log-rank test). In the early t reatment era, a significant difference was seen for all forms of cance r combined (P<.001), with 10-year Kaplan-Meier estimates (+/-SE) of 37 %+/-3% for black children and 50%+/-1% for white children. This differ ence largely reflected the poorer prognosis of black children with the most common childhood cancer, acute lymphoblastic leukemia. In the re cent treatment era, there were no significant differences in treatment outcome by race for specific disease categories or for all forms of c ancer combined, Ten-year survival rates were 67%+/-6% for black childr en and 66%+/-3% for white children, indicating a significantly greater improvement in the former group. Conclusion.-With equal access to eff ective contemporary treatment, black children with cancer fare as well as white children when treated with protocol-based therapy at a pedia tric oncology research center.