Childhood Cancer Survival Rates Lower on Texas-Mexico Border; SDoH-Focused Cancer Research Needed


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Cancer survival disparities are well documented in adults living along the US-Mexico border, but it is unknown whether these disparities similarly affect children with leukemia, the most common cancer in children and teens.

A Baylor College of Medicine study in the journal Cancer helps bridge this knowledge gap.

Let’s explore the findings of the study, what these findings mean for Latino children and families living along the Texas-Mexico border, and how to address cancer disparities in the Latino population.

Study Findings on Leukemia in South Texas

Baylor College of Medicine researchers examined the survival rates of acute lymphocytic leukemia (ALL), the most common form of pediatric leukemia, in children living along the Texas-Mexico border.

The study included 6,002 Texas children from birth to age 19 who were diagnosed with ALL between 1995 and 2017.

childhood cancer leukemia

After accounting for various factors that affect survival rates, such as poverty level, age at diagnosis, sex, and race/ethnicity, researchers found that children with ALL living along the Texas-Mexico border had a 30% increased risk for death compared to children living in non-border areas.

These findings suggest that the 30% increased risk of death in children living along the border may be influenced by social determinants of health (SDoH) factors not accounted for in this study, such as environmental exposures and access to nutritional food and safe places to exercise.

“Given the limitation of cancer registries’ ability to collect information regarding social determinants of health, we were unable to evaluate and adjust for these factors in our analyses,” according to the study. “There is an urgent need to incorporate comprehensive assessments of social determinants of health into both clinical trials and cancer registries to capture how these factors affect survival outcomes.”

Researchers also evaluated survival rates for children with acute myeloid leukemia (AML) living along the Texas-Mexico border, but survival estimates did not vary by border versus non-border residence.

What the Leukemia Study’s Findings Mean for Latinos

Nearly 5 million people — 69% of whom are Latinos — live in South Texas, which stretches from south San Antonio to the Texas-Mexico border.

Latinos in this area suffer a disproportionately higher cancer risk compared to the rest of the US.

For instance, South Texas Latino children have a 32% increased risk for pediatric leukemia compared to non-Latino children nationwide.

These devastating disparities are rooted in vast social inequities, including:

  • Lack of health insurance: 30% in South Texas are uninsured; 23% in Texas.
  • Care: 44.8% in South Texas don’t have a usual source of healthcare; 31.9% in Texas.
  • Financial strain: 25% in South Texas live in poverty; 15.8% in Texas.
  • Income: 22% in South Texas earned less than 150% of the federal poverty line; 14.9% in Texas.
  • Education: 30% in South Texas are not high-school graduates; 16.3% in Texas.
  • Language: 41% in South Texas speak Spanish as their primary language; 29.3% in Texas.

Of these social inequities, only income was accounted for in the Baylor College of Medicine study.

This means a wide variety of additional SDoH factors that could be influencing health outcomes in South Texas, including cancer survivorship rates.

“While there have been tremendous achievements in maximizing cure rates for children with leukemia in the United States, not everyone is benefiting from these advances. We know there are differences in survival, with children from historically marginalized Hispanic and Black communities faring worse than white children,” Dr. Maria Castellanos, lead researcher of the study at Baylor College of Medicine, told Inside Precision Medicine.

“There is an urgent need to identify the reasons why these differences in survival are occurring, including an assessment of the barriers to obtaining health care and strategies to successfully reduce barriers.”

Addressing Latino Cancer Disparities

In February 2023, Dr. Amelie G. Ramirez of UT Health San Antonio announced the new “Avanzando Equidad de Salud: Latino Cancer Health Equity Research Center” thanks to a four-year, $4.08-million grant from the American Cancer Society.

amelie ramirez
Dr. Amelie G. Ramirez

The Avanzando Equidad de Salud Center is a response to the severe cancer burden facing Latinos in South Texas.

The center has a special focus – addressing SDoH factors that impact Latino health outcomes, including cancer survivorship.

“Our new center will conduct a unique combination of community-engaged research, training, patient assessment, and advocacy to address the social determinants of health — such as access to healthcare, financial strain, and food insecurity —that deter Latinos from equitable access to cancer care, prevention, early detection, and treatment,” said Ramirez, leader of the Salud America! Latino health equity program, and head of the Department of Population Health Sciences and the Institute for Health Promotion Research at UT Health San Antonio.

As part of this grant, Salud America! is raising awareness about the important role SDoH screening plays in addressing social needs and improving health outcomes.

We are also spotlighting effective screening tools and uplifting healthcare facilities that have implemented a successful SDoH screening program to improve health outcomes in vulnerable patient populations, such as Latinos.

“We want to reduce the risks for South Texans in developing cancer and improve their quality of life should they be diagnosed with cancer,” Ramirez said.

You Can Help Address Cancer Disparities, Too

Select your county and get a Health Equity Report Card by Salud America! at UT Health San Antonio.

In your report card, you will see maps, data, and gauges to compare social needs to the rest of your state and nation.

You can email your Health Equity Report Card to local leaders to stimulate community change.

You can also use the data in your materials or share on social media to raise awareness about the importance of SDoH screening in addressing cancer disparities in the Latino population.

Get your Health Equity Report Card!

Childhood Leukemia Resources

Need more information on childhood leukemia?

The American Cancer Society is the place to go. Learn more about navigating childhood leukemia, including treatment details, statistics, and information and services to help with cancer treatment journeys.

For financial assistance, Leukemia Texas has your back. The organization is dedicated to improving the lives of those with leukemia through the funding of research and the Patient Aid program, which provides financial assistance for Texas leukemia patients who need help paying for prescribed treatment expenses left uncovered by insurance.

Texas Children’s Cancer Center is aware of the emotional, mental, and financial challenges of treating cancer. Read personal stories about leukemia patients who are currently receiving or have received cancer treatment at the largest pediatric cancer and hematology center in Texas.

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