Disparities in Growth Hormone Deficiency Screening, Evaluation, Diagnosis, and Treatment Among at-Risk Childhood Cancer Survivors in the US.
AI interpretation is pending for this paper.
Open original publication →What the AI sees
Not AI summarized yet.
Research significance
Pending deeper interpretation.
Source abstract
BACKGROUND: Minoritized childhood cancer survivors (CCS) may encounter barriers to timely late effects surveillance. We aimed to evaluate clinical and demographic differences in the likelihood of, and timing to, growth hormone deficiency (GHD) screening, evaluation, diagnosis, and treatment among at-risk CCS treated with radiation therapy (RT). PROCEDURE: Retrospective chart review identified children diagnosed with cancer at less than 19 years old (2010-2020), who received a cranial radiation therapy (CRT) or craniospinal irradiation (CSI) dose of ≥18 Gy or a total body irradiation (TBI) dose of ≥12 Gy, and had at least 2 years of post-RT follow-up. Logistic regression models were used to calculate odds ratios (OR) and confidence intervals (CI) for outcomes based on demographic and clinical predictor variables. RESULTS: We identified 214 eligible patients. The odds of not being treated after a GHD diagnosis were 20.48-times greater (95% CI: 1.15-364) in non-Hispanic Blacks than in non-Hispanic Whites. CCS living in neighborhoods with the highest ADI quartile (i.e., greatest socioeconomic disadvantage) had higher odds (OR = 3.98, 95% CI: 1.05-15.10) of not completing an endocrine visit than those in lower ADI quartiles. Those who received CRT and those diagnosed with cancer at age ≥12 years had lower odds of being screened, referred to endocrine, and prescribed growth hormone than those who received TBI and those who were diagnosed at age less than 5 years, respectively. CONCLUSIONS: We observed differences based on socioeconomic status, RT type, and age of cancer diagnosis in the likelihood of GHD screening, evaluation, diagnosis, and treatment, suggesting the need to investigate contributors to these disparities.