Racial and ethnic disparities in pediatric cancer incidence among children and young adults in the United States by single year of age

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Abstract

Background: Incidence rates of pediatric cancers in the United States are typically reported in 5-year age groups, obscuring variation by single year of age. Additionally, racial and ethnic variation in incidence is typically presented in broad categories rather than by narrow age ranges. Methods: The Surveillance, Epidemiology, and End Results (SEER) 18 data (2000-2017) were examined to calculate frequencies and age-adjusted incidence rates among individuals aged birth to 39 years. Incidence rate ratios (IRRs) and 95% confidence intervals (95% CIs) were estimated as the measure of association for rate comparisons by race and Hispanic origin overall and by single year of age. Results: Several histologic types showed substantial variation in race/ethnicity-specific and overall rates by single year of age. Overall, Black children and young adults experienced substantially decreased incidence of acute lymphoid leukemia (IRR, 0.52; 95% CI, 0.49-0.55) compared to Whites, and this decreased incidence was strongest at ages 1 through 7 years and 16 through 20 years. Hispanic individuals experienced decreased overall incidence of Hodgkin lymphoma (IRR, 0.50; 95% CI, 0.48-0.52) and astrocytoma (IRR, 0.54; 95% CI, 0.52-0.56) and increased risk of acute lymphoblastic leukemia (IRR, 1.46; 95% CI, 1.42-1.51) compared to non-Hispanic Whites, and the increased risk was strongest at ages 10 through 23 years. Substantial decreased risk across many tumor types was also observed for Asian/Pacific Islanders and American Indian/Alaska Natives. Conclusions: Examination of incidence rates for pediatric cancers by narrow age groups may provide insights regarding etiological differences in subgroups. Additionally, variation in age-specific incidence rates by race and ethnicity may enable hypothesis generation on drivers of disparities observed.

Original languageEnglish (US)
Pages (from-to)3651-3663
Number of pages13
JournalCancer
Volume127
Issue number19
Early online dateJun 21 2021
DOIs
StatePublished - Oct 1 2021

Bibliographical note

Funding Information:
This work was supported by the National Cancer Institute (T32 CA099936) and the Children's Cancer Research Fund, Minneapolis, Minnesota.

Publisher Copyright:
© 2021 American Cancer Society

Keywords

  • childhood cancer
  • disparities
  • epidemiology
  • incidence
  • pediatric
  • race and ethnicity
  • trends

PubMed: MeSH publication types

  • Journal Article

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