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

Ivo S Muskens; Qianxi Feng; Stephen S Francis; Kyle M Walsh; Roberta Mckean-Cowdin; William J Gauderman; Adam J de Smith; Joseph L Wiemels

doi:10.1093/noajnl/vdaa089

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

Neurooncol Adv. 2020 Jul 22;2(1):vdaa089. doi: 10.1093/noajnl/vdaa089. eCollection 2020 Jan-Dec.

Authors

Ivo S Muskens¹, Qianxi Feng¹, Stephen S Francis², Kyle M Walsh³, Roberta Mckean-Cowdin¹, William J Gauderman⁴, Adam J de Smith¹, Joseph L Wiemels¹

Affiliations

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

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.

Keywords: SEER; SES; ethnicity; pediatric brain tumor; risk factors.