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@ARTICLE{Wellbrock:302985,
      author       = {M. Wellbrock and A. Borkhardt$^*$ and C. M. Ronckers and C.
                      Spix and D. Grabow and A.-L. Filbert and D. Wollschläger
                      and F. Erdmann},
      title        = {{S}ocioeconomic background and childhood cancer survival in
                      {G}ermany: {A} nationwide assessment based on data from the
                      {G}erman {C}hildhood {C}ancer {R}egistry.},
      journal      = {International journal of cancer},
      volume       = {nn},
      issn         = {0020-7136},
      address      = {Bognor Regis},
      publisher    = {Wiley-Liss},
      reportid     = {DKFZ-2025-01432},
      pages        = {nn},
      year         = {2025},
      note         = {epub},
      abstract     = {Social inequalities in childhood cancer survival have been
                      observed in many countries, including European nations with
                      universal healthcare systems, suggesting that not all
                      children with cancer have benefited equally from diagnostic
                      and therapeutic enhancements. Despite the growing
                      socioeconomic diversity within Germany's large population,
                      little is known about the extent of social inequalities in
                      German childhood cancer survival. Using German Childhood
                      Cancer Registry data, we identified all children with a
                      cancer diagnosis before the age of 15 years in 1997-2016 in
                      Germany (N = 35,443). Based on individual residential
                      address information (at time of diagnosis) we applied the
                      German Index of Socioeconomic Deprivation (GISD) to measure
                      area-based socioeconomic status. Using Cox proportional
                      hazards models, we assessed the association between absolute
                      area-based socioeconomic deprivation (AASD) and 10-year
                      overall survival (OS) (end of follow-up: 15 January 2023) to
                      estimate hazard ratios (HR) and corresponding $95\%$
                      confidence intervals (CI). The multivariable analyses
                      revealed a null association for AASD and 10-year OS for all
                      cancers combined (HRadj = 1.00, $95\%$ CI 0.97; 1.03). Among
                      children diagnosed with acute myeloid leukaemia and germ
                      cell tumors, a higher AASD (higher levels of deprivation)
                      appeared to be associated with worse survival, particularly
                      pronounced in boys. The opposite was observed among children
                      diagnosed with central nervous system tumors. Contrary to
                      reports from other European countries, we found little
                      evidence for social inequalities in childhood cancer
                      survival in Germany when analysing the GISD. Further
                      research assessing individual-level measures of
                      socioeconomic status is warranted.},
      keywords     = {Germany Childhood Cancer Registry (Other) / childhood
                      cancer survival (Other) / social inequalities (Other) /
                      socioeconomic deprivation (Other)},
      cin          = {ED01},
      ddc          = {610},
      cid          = {I:(DE-He78)ED01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40673348},
      doi          = {10.1002/ijc.70042},
      url          = {https://inrepo02.dkfz.de/record/302985},
}