Is there a socioeconomic variation in survival from renal tumours in children and young people resident in northern England (1968–2012)?

Abstract

BackgroundDespite strong evidence of a social gradient in cancer survival among UK adults, studies in children and young people remain inconclusive and have not included renal tumours. This study investigated the relationship between socioeconomic status and survival from renal tumours among children and young people. ProcedureKaplan-Meier estimation and Cox regression were used to analyse survival for all 209 renal tumours in children and young people (0–24 years) diagnosed 1968–2012 and registered by a specialist population-based registry. Sociodemographic and clinicopathologic variables, including paternal occupation at birth, were also analysed. ResultsNo significant disparity in overall renal tumour and Wilms tumour (WT) survival was observed according to paternal social class [p=0.988 and 0.808, respectively]. The strongest predictor of survival was stage, with late stage (III–IV) disease having a 4-fold higher risk of death compared to early stage (I–II) disease [p<0.001]. Similarly, high mortality-risk was seen for late stage WT in children aged 0–14 years (Hazard Ratio=6.37; 95% CI=2.60–15.59). ConclusionsThis study did not detect a significant social gradient in renal tumour survival. The identification of tumour stage as a strong predictor of survival irrespective of age, necessitates the development of appropriate public health interventions that target early diagnosis and treatment.