Journal article
Area deprivation and pediatric cancer mortality: An analysis of 2000-2020 state cancer registry data
Cancer epidemiology, biomarkers & prevention, Vol.34(10), pp.1722-1729
10/03/2025
DOI: 10.1158/1055-9965.EPI-25-0637
PMID: 40788028
Abstract
Compared to adult cancers, less research has been conducted on health disparities in pediatric cancer outcomes. The effect of neighborhood deprivation, as measured by the Area Deprivation Index (ADI), on pediatric cancer survival is not well understood, especially among diverse populations.
We conducted a population-based longitudinal study using data from the Iowa Cancer Registry and Louisiana Tumor Registry. The study included children diagnosed with cancer in the two states ages 0-19 years from 2000 to 2020. The primary exposure was ADI, and the primary outcome was cancer-specific mortality. Cox regression models with shared frailty to account for the geographic clustering of individuals were used to compute the association between ADI and mortality.
A total of 6,982 children were included between the two states: 2,939 in Iowa and 4,043 in Louisiana. In the adjusted analysis, higher deprivation was positively associated with poorer pediatric cancer survival. Compared to children in the least deprived neighborhoods, those in the most deprived neighborhoods had a 50% higher risk of cancer death (95% CI: 1.18-1.89) and a 3.15 times greater risk of early cancer death (95% CI: 1.39-7.16). Among children with extracranial solid tumors, those in the most deprived neighborhoods had a 54% higher risk of cancer death (95% CI: 1.04-2.27) compared to those in the least deprived neighborhoods.
Higher ADI is associated with higher pediatric cancer mortality, highlighting the importance of social drivers of health on pediatric cancer outcomes.
Neighborhood-level interventions will likely be needed to improve pediatric cancer outcomes.
Details
- Title: Subtitle
- Area deprivation and pediatric cancer mortality: An analysis of 2000-2020 state cancer registry data
- Creators
- Emma Hymel - University of Nebraska Medical CenterEdward S Peters - University of Nebraska Medical CenterKendra L Ratnapradipa - University of Nebraska Medical CenterCheng Zheng - University of Nebraska Medical CenterJenna Allison - University of Nebraska Medical CenterMei-Chin Hsieh - Louisiana State University Health Sciences Center New OrleansSarah H Nash - University of IowaShinobu Watanabe-Galloway - University of Nebraska Medical Center
- Resource Type
- Journal article
- Publication Details
- Cancer epidemiology, biomarkers & prevention, Vol.34(10), pp.1722-1729
- DOI
- 10.1158/1055-9965.EPI-25-0637
- PMID
- 40788028
- NLM abbreviation
- Cancer Epidemiol Biomarkers Prev
- ISSN
- 1055-9965
- eISSN
- 1538-7755
- Publisher
- AMER ASSOC CANCER RESEARCH
- Grant note
- Child Health Research Institute, University of Nebraska Medical Center (CHRI)State of Nebraska through the Pediatric Cancer Research Group, part of the Child Health Research Institute: HHSN261201800012I NCI, NIH, Department of Health and Human ServicesUniversity of IowaState of Iowa: 3P30CA086862 University of Iowa Holden Comprehensive Cancer CenterLouisiana State University Health Sciences Center, New OrleansCenters for Disease Control and Prevention/National Program of Cancer RegistriesNCI
This research was supported by the State of Nebraska through the Pediatric Cancer Research Group, part of the Child Health Research Institute. The Iowa Cancer Registry/State Health Registry of Iowa is funded in whole or in part with federal funds from the NCI, NIH, Department of Health and Human Services, under Contract No. HHSN261201800012I and in part with funds from the University of Iowa and funds from the State of Iowa. S.H. Nash is additionally supported in part by the University of Iowa Holden Comprehensive Cancer Center (3P30CA086862). The Louisiana Tumor Registry is supported by the Louisiana State University Health Sciences Center, New Orleans, the Centers for Disease Control and Prevention/National Program of Cancer Registries, and the NCI.
- Language
- English
- Electronic publication date
- 08/11/2025
- Date published
- 10/03/2025
- Academic Unit
- Epidemiology; Community and Behavioral Health
- Record Identifier
- 9984946698102771
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