Poverty and childhood cancer incidence in the United States

Abstract

This study examined socioeconomic differentials in cancer incidence rates during 2000-2005 among children aged 0-19 in the United States. The data on childhood cancers, which were classified by the International Classification of Childhood Cancer, Third Edition (ICCC-3), were obtained from the Surveillance, Epidemiology, and End Results program. The socioeconomic status of residential area at diagnosis was estimated by county-level poverty rate in Census 2000, i.e., percentage of persons in the county living below the national poverty thresholds. Counties were categorized as low-, medium-, and high-poverty areas when the poverty rates were <10, 10-19.99, and 20% or higher, respectively. The results showed that medium- and high-poverty counties had lower age-adjusted incidence rates than low-poverty counties for total childhood cancers combined, central nervous system neoplasms (ICCC group III), neuroblastoma (group IV), renal tumors (group VI), and other malignant epithelial neoplasms and malignant melanomas (group XI). When the data were stratified by race, these associations were observed among whites, but not blacks. For leukemia (group I), poor counties had higher incidence rates than affluent counties for whites, but lower rates for blacks. This ecologic study provides perspective on area socioeconomic variations in childhood cancer incidence that warrants further research.

Risk of malignant childhood germ cell tumors in relation to demographic, gestational, and perinatal characteristics

“…In contrast, a pooled population-based analysis of five US states, which included California births from 1988–1997, did not find an association with maternal education [37]. A nationwide US study also suggested a lower risk of GCTs in higher-poverty areas, but poverty metrics were on the county-level, making results difficult to compare to our individual or census-tract level measures [38]. The small number of studies, and the varying measures of socioeconomic status used, suggest a need for more research in this area.…”

The burden of childhood cancer in Mexico: Implications for low‐ and middle‐income countries

“…These inconsistent findings demonstrate the lack of basic professional and hospital infrastructure and the high mortality rate of childhood cancer. Furthermore, poverty is an important cofactor in this chain of unfavorable events …”

Descriptive Epidemiology in Mexican children with cancer under an open national public health insurance program

“…This fact, from the public health point of view, should direct attention to the triangle of poverty, malnutrition and early infections that most likely play a very important role in the etiology and incidence of childhood cancer in the PMI population. Recent studies [21] have suggested that the incidence of cancer among children living in poverty is much higher than in more affluent populations. This deficiency might be a factor that can account for the higher incidence of acute lymphoblastic leukemia in comparison to those children treated by the socialized healthcare systems in Mexico, in which the socioeconomic and cultural level is much higher.…”