Understanding Geographic Variation of Pediatric Cancer Could Lead to Improved Care

There are many important factors to consider when examining the 15,000 new cases of pediatric cancer each year in the United States, such as the geographic variation in cancer diagnoses. Previously, however, studies examining the geographic variation in pediatric cancer have not been conducted on a state level.

This prompted the CDC to conduct a comprehensive analysis of pediatric cancer cases to better understand the role of geographic variation. Understanding the prevalence of pediatric cancer by state can result in improved access to specialized treatment, increased clinical trial enrollment, and further research on variations in pediatric cancer, according to a report from the CDC.

Officials analyzed 171,432 cases from the United States Cancer Statistics (USCS) that occurred from 2003 to 2014, including data from the CDC’s National Program of Cancer Registries, and the National Cancer Institute’s Surveillance, Epidemiology, and End Results program. The data represented more than 99% of the United States population, and included all first primary cases of malignant cancer in patients under the age of 20.

Cancer rates were higher in boys than girls, and more common in children aged 0-4 and 15-19 than children in the age groups of 5-9 and 10-14. White children were the most likely to receive a cancer diagnosis across all racial and ethnic groups, while black children were the least likely, according to the report.

The most common pediatric cancer diagnosis found was leukemia, with 45.7 cases per million people, followed by brain tumors at 30.9 cases per million, and then lymphomas at 26.2 cases per million. Leukemia was most common cancer type in the West, while lymphomas and brain tumors were more prevalent in the Northeast, according to the report.

The Northeast had the highest rate of pediatric cancer across all age groups, and both white and black children, followed by the Midwest, and the West. The South had the lowest prevalence among black and white children, yet the highest prevalence among Hispanic children. New Hampshire, New Jersey, and the District of Columbia, were the states with the most incidents, while South Carolina and Mississippi had the lowest pediatric cancer rates, according to the report.

Pediatric cancer rates were higher in the 25% of the wealthiest counties, as well as metropolitan areas with a population exceeding 1 million, according to the report.

The CDC notes that several factors may influence geographic variation in pediatric cancer rates, including: exposure to carcinogens such as air pollution, secondhand smoke, and contaminated food or drinking water; exposure to radiation; genetic variations among certain groups that predispose them to cancer; having a large population of racial/ethnic groups who have a higher rate of certain cancer types; and finally, increased access to care that results in earlier detection of cancer.

Moving forward, the CDC urges cancer control centers and health care providers to use the knowledge of geographic variation in pediatric cancer to address concerns by improving access to care based on specific needs; organizing clinical trials; and finally, leading further investigation.

Reference

Geographic Variation in Pediatric Cancer Incidence.Morbidity and Mortality Weekly Report. The CDC’s website.https://www.cdc.gov/mmwr/volumes/67/wr/mm6725a2.htm#suggestedcitation. Accessed July 26, 2018.