Table 2.

Area-level SES in relation to overall survival among children with ALL in the NCDB, diagnosed between 2004 and 2019, by survival cohort

VariableMultivariable models
Total cohortConditional survival of ≥2 yearsConditional survival of ≥5 years
aHR (95% CI)P valueaHR (95% CI)P valueaHR (95% CI)P value
Neighborhood income and education quartiles at cancer diagnosis (ref: Q4: highest education + income quartiles) 
Lowest education and income quartiles 1.55 (1.29-1.88) <.001 1.70 (1.28-2.26) .001 1.87 (1.17-3.00) .032 
All other education/income quartiles 1.24 (1.07-1.44)  1.37 (1.10-1.70)  1.37 (0.96-1.97)  
Year of cancer diagnosis, per 1 year increase 0.96 (0.94-0.97) <.001 0.94 (0.92-0.96) <.001 0.95 (0.91-0.99) .015 
Age at cancer diagnosis, y (ref: 1-4) 
5-9 1.51 (1.31-1.73) <.001 1.24 (1.02-1.51) <.001 1.10 (0.77-1.55) <.001 
10-14 3.15 (2.76-3.59)  2.50 (2.08-3.01)  2.38 (1.72-3.29)  
15-17 4.61 (4.01-5.29)  3.46 (2.83-4.24)  3.71 (2.65-5.21)  
Sex (ref: female), male N/A N/A N/A N/A 1.29 (1.002-1.67) .048 
Race/ethnicity (ref: non-Hispanic White) 
Non-Hispanic Black 1.37 (1.17-1.62) <.001 1.37 (1.07-1.75) .012 N/A N/A 
American Indian/Alaska Native 1.16 (0.65-2.06)  1.38 (0.61-3.11)  N/A  
Asian 0.97 (0.75-1.26)  0.97 (0.66-1.43)  N/A  
Hispanic 1.20 (1.06-1.35)  1.34 (1.13-1.60)  N/A  
Other 1.49 (1.04-2.12)  1.35 (0.76-2.41)  N/A  
Primary payer at diagnosis (ref: private insurance) 
Medicaid 1.18 (1.06-1.32) .0047 1.13 (0.96-1.33) .097 0.83 (0.63-1.11) .53 
Other/uninsured 1.14 (0.93-1.40)  0.91 (0.65-1.25)  0.95 (0.55-1.65)  
Unknown 1.42 (1.09-1.84)  1.44 (1.00-2.07)  1.21 (0.64-2.31)  
Charlson-Deyo score (ref: none), ≥1 1.45 (1.21-1.73) <.001 N/A N/A N/A N/A 
Time to treatment (ref: within 1 week), ≥1 week 1.16 (1.00-1.35) .051 1.23 (0.99-1.53) .056 N/A N/A 
Distance in miles (ref: ≤50) 
51-100 N/A N/A N/A N/A N/A N/A 
>100 N/A  N/A  N/A  
Rural-urban continuum codes (ref: metro), non-metro/rural N/A N/A N/A N/A N/A N/A 
VariableMultivariable models
Total cohortConditional survival of ≥2 yearsConditional survival of ≥5 years
aHR (95% CI)P valueaHR (95% CI)P valueaHR (95% CI)P value
Neighborhood income and education quartiles at cancer diagnosis (ref: Q4: highest education + income quartiles) 
Lowest education and income quartiles 1.55 (1.29-1.88) <.001 1.70 (1.28-2.26) .001 1.87 (1.17-3.00) .032 
All other education/income quartiles 1.24 (1.07-1.44)  1.37 (1.10-1.70)  1.37 (0.96-1.97)  
Year of cancer diagnosis, per 1 year increase 0.96 (0.94-0.97) <.001 0.94 (0.92-0.96) <.001 0.95 (0.91-0.99) .015 
Age at cancer diagnosis, y (ref: 1-4) 
5-9 1.51 (1.31-1.73) <.001 1.24 (1.02-1.51) <.001 1.10 (0.77-1.55) <.001 
10-14 3.15 (2.76-3.59)  2.50 (2.08-3.01)  2.38 (1.72-3.29)  
15-17 4.61 (4.01-5.29)  3.46 (2.83-4.24)  3.71 (2.65-5.21)  
Sex (ref: female), male N/A N/A N/A N/A 1.29 (1.002-1.67) .048 
Race/ethnicity (ref: non-Hispanic White) 
Non-Hispanic Black 1.37 (1.17-1.62) <.001 1.37 (1.07-1.75) .012 N/A N/A 
American Indian/Alaska Native 1.16 (0.65-2.06)  1.38 (0.61-3.11)  N/A  
Asian 0.97 (0.75-1.26)  0.97 (0.66-1.43)  N/A  
Hispanic 1.20 (1.06-1.35)  1.34 (1.13-1.60)  N/A  
Other 1.49 (1.04-2.12)  1.35 (0.76-2.41)  N/A  
Primary payer at diagnosis (ref: private insurance) 
Medicaid 1.18 (1.06-1.32) .0047 1.13 (0.96-1.33) .097 0.83 (0.63-1.11) .53 
Other/uninsured 1.14 (0.93-1.40)  0.91 (0.65-1.25)  0.95 (0.55-1.65)  
Unknown 1.42 (1.09-1.84)  1.44 (1.00-2.07)  1.21 (0.64-2.31)  
Charlson-Deyo score (ref: none), ≥1 1.45 (1.21-1.73) <.001 N/A N/A N/A N/A 
Time to treatment (ref: within 1 week), ≥1 week 1.16 (1.00-1.35) .051 1.23 (0.99-1.53) .056 N/A N/A 
Distance in miles (ref: ≤50) 
51-100 N/A N/A N/A N/A N/A N/A 
>100 N/A  N/A  N/A  
Rural-urban continuum codes (ref: metro), non-metro/rural N/A N/A N/A N/A N/A N/A 

Full univariable and multivariable results are found in supplemental Tables 1-3. N/A signifies variables that were not retained in multivariable modeling.

Q4, quartile 4; Ref, reference.

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