When the eye cancer retinoblastoma is diagnosed in racial and ethnic minority children whose families don't have private health insurance, it often takes a more invasive, potentially life-threatening course than in other children, probably because of delays in diagnosis, Dana-Farber/Children's Hospital Cancer Center (DF/CHCC) researchers will report at the 26th annual meeting of the American Society of Pediatric Hematology Oncology being held in Miami, April 24-27.
By analyzing data and tumor samples from 203 children across the United States who had been treated for retinoblastoma, the investigators found that the disease was more invasive at diagnosis in patients who were non-white, Hispanic, uninsured, or covered by Medicaid. Researchers now need to explore why the disease tends to be diagnosed later in such children and how those delays can be eliminated, said the study authors.
Retinoblastomas are tumors that develop during childhood in the light-sensitive retina at the back of the eye. There are about 350 new cases diagnosed each year in the United States. Treatment may require surgical removal of the affected eye and, if the disease is likely to spread, follow-up chemotherapy.
"The longer that retinoblastomas grow before they're diagnosed and treated, the more invasive they become," said the study's lead author, Adam Green, MD, of DF/CHCC. "In this study, we used tumor invasiveness as an indicator of delays in disease diagnosis."
Data and tumor tissue used in the study came from pediatric retinoblastoma patients participating in a clinical trial run by the Children's Oncology Group, a consortium of more than 8,000 childhood cancer experts on three continents. All the patients had the diseased eye surgically removed, and those whose disease was deemed likely to spread received chemotherapy.
Investigators collected data on patients' insurance status, race, and ethnicity. The tumor tissue samples were examined by pathologists for signs that the tumors would metastasize.