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Original research
Role of ethnicity and socioeconomic status (SES) in the presentation of retinoblastoma: findings from the UK
  1. Rabia Bourkiza1,
  2. Phillippa Cumberland2,
  3. Ido Didi Fabian1,3,4,
  4. Hiranya Abeysekera5,
  5. Manoj Parulekar5,
  6. Mandeep S Sagoo1,4,6,
  7. Jugnoo Rahi2,4,7,
  8. M Ashwin Reddy1,4,6
  1. 1Moorfields Eye Hospital NHS Foundation Trust, London, UK
  2. 2Ulverscroft Vision Research Group, Great Ormond Street Institute of Child Health, UCL, London, UK
  3. 3Ocular Oncology Service, Goldschleger Eye Institute, Sheba Medical Centre, Tel-Aviv University, Tel Aviv, Israel
  4. 4NIHR Biomedical Research Centre, Moorfields Eye Hospital and University College London Institute of Ophthalmology, London, UK
  5. 5Department of Paediatric Ophthalmology, Birmingham Children’s Hospital, Birmingham, UK
  6. 6Ophthalmology, Barts Health NHS Trust, London, UK
  7. 7Paediatric Ophthalmology, Great Ormond Street Institute of Child Health, University College London, London, UK
  1. Correspondence to Dr Rabia Bourkiza; r.bourkiza{at}nhs.net

Abstract

Background The relationship between the ethnic background or socioeconomic status (SES) and late retinoblastoma (Rb) presentation in the UK is unclear. We aimed to investigate if such correlations exist in a cohort of non-familial Rb cases.

Methods A cross-sectional study based at the two centres providing Rb care in the UK. Included were non-familial Rb cases that presented from January 2006 to December 2011. Epidemiological and clinical data were retrieved from medical charts, as well as patients’ postcodes used to obtain the Index of Multiple Deprivation (IMD) score. A postal questionnaire was sent to participants’ parents to collect further, person-level, information on languages spoken and household socioeconomic position. Statistical correlations to advanced Rb at presentation as well as to treatment by enucleation and need for adjuvant chemotherapy were investigated.

Results The cohort included 189 cases, 98 (51.8%) of which were males. The median age at diagnosis was 16 months (IQR 8–34 months). Of the study patients, 153 (81%) presented with advanced Rb; 78 (41%) with group D and 75 (40%) with group E Rb. A total of 134 (72%) patients were treated with enucleation. South Asian ethnicity and being in the most deprived IMD quintile were associated with a higher likelihood of presentation with advanced disease, but these estimates did not reach statistical significance. Older age at presentation was associated with enucleation and bilateral disease with adjuvant chemotherapy.

Conclusions In this national UK study of patients with non-familial Rb, there was no evidence of an association of ethnicity or SES and the risk of presenting with advanced disease. These findings may reflect equality in access of healthcare in the UK.

  • epidemiology
  • neoplasia
  • retina
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjophth-2019-000415

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    Footnotes

    • Contributors RB, MAR, PC, MP JR and MSS planned the study. RB and HA collected the data and conducted the questionnaires. PC, RB and IDF analysed the results. RB wrote the paper, and all the authors modified the manuscript and agreed on submission. RB submitted the manuscript.

    • Funding Research grant from the Royal National Institute of the Blind, UK. PC was funded by the Ulverscroft Foundation.

    • Disclaimer The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. The funding organisation had no role in the design or conduct of this research.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Patient consent for publication Not required.

    • Ethics approval The study was approved by the National Research Ethics Committee (Reference 11/LO/0981).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available upon request.