Pediatric cancer rates are highest in the Northeast U.S. and lowest in the South, according to a new report from the CDC, while leukemia is more prevalent in the West. But, the researchers noted, childhood cancer remains rare enough that such variables are more significant to care providers than the public.
“Knowledge of pediatric cancer incidence variation by state and cancer type can prompt local and state cancer registries to evaluate reporting and diagnostic standards,” wrote David Siegel, MD, and coauthors. “Understanding geographic variation in incidence rates can help cancer control planners and clinicians address obstacles in access to care, which is especially relevant to states with large distances to pediatric oncology centers.”
The CDC collected data for 2003-2014 from the National Program of Cancer Registries and the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) program. During that period, 171,432 cases of pediatric cancer were identified—with an incidence rate of 173.7 cases per one million children. Leukemia was the most common cancer (45.7 cases per million), following by brain tumors (30.9 cases) and lymphomas (26.2 cases).
Other key data points included:
- Incidence rates were 188 per one million in the Northeast, compared to 168 in the South.
- Males (181.5 cases per million) were more likely to be diagnosed compared to females (165.5)
- Cancer was most prevalent in children 4 years or younger (228.9), followed by those 15 to 19 (213.3), 10 to 14 (133) and 5 to 9 (122.6).
- White children (184.4) were more likely to be diagnosed than black children (133.3).
- New Hampshite (205.5), Washington, D.C. (194), and New Jersey (192.3) had the highest rates, while Mississippi (145.3) and South Carolina (149.3) had the lowest.
The researchers noted four possible factors that cause geographic variation in childhood cancer:
- Differences in exposure to carcinogens, including air pollution, secondhand smoke and contaminated water.
- Genetic variation in certain populations.
- Differences in cancer types by race-ethnicity.
- Varying access to care and quality of detection methods.
While Siegel et al. emphasized these factors, the team noted cancer rates are affected by both genetic and environmental factors.
“[G]eographic variation might be affected by age, economic status or rural/urban classification,” the team wrote. “Similar to the findings from this report, recent data detailing adult cancers also indicate that the highest cancer incidence rates are in the Northeast. Rates of cancer types mostly affecting adults also varied by rural/urban status; some of these differences in adults might be related to factors such as obesity or smoking, which might or might not also explain rural/urban variation in pediatric cancer.”
The authors noted that this data should help guide professionals, rather than alarm those populations with higher rates of pediatric cancer.
“Because five-year pediatric cancer survival is greater than 80 percent and most cancer survivors require close monitoring by specialists throughout life, state-specific data by cancer type and patient age might help public health planners address ongoing chronic care needs,” Seigel et al wrote. “In addition, state-specific data by cancer type and patient age might help clinical trial organizers predict patient accrual. Finally, healthcare practitioners and researchers can use these data to guide investigations related to causes of pediatric cancer incidence variation.”
Nicholas joined TriMed in 2016 as the managing editor of the Chicago office. After receiving his master’s from Roosevelt University, he worked in various writing/editing roles for magazines ranging in topic from billiards to metallurgy. Currently on Chicago’s north side, Nicholas keeps busy by running, reading and talking to his two cats.