Abstract C096: Disparities in incidence rates of pediatric neuroblastoma in the United States: A Surveillance, Epidemiology, and End Results (SEER) Program Study using HD*Calc
Authors: Napit Krishtee , Hymel Emma , Kabayundo Josiane , Watanabe-Galloway Shinobu 
Published: December 2023

Abstract
Even though racial, rural-urban and socioeconomic disparities have been identified in pediatric neuroblastoma incidence rates, the exact measurement of the disparities is rarely done. The study was conducted to generate summary measures to evaluate health disparities in the age-adjusted incidence rates of neuroblastoma. We used Surveillance, Epidemiology, & End Results (SEER) 17 registries data from 2000 to 2020 to identify pediatric neuroblastoma cases, race and ethnicity, area of residence, and median income and to calculate age-adjusted incidence rates. We then used HD*Calc software to calculate the trends of range difference (RD), range ratio (RR), and a pairwise comparison of RD and RR based on racial, rural-urban, and median household income. Out of 3592 patients identified, 57% were Non-Hispanic Whites, 90% lived in metropolitan counties, 54% were male, and 56% had income less than $75,000. The absolute RD for race and ethnicity from 2000 to 2020 calculated by comparing the incidence rate of less-advantaged race/ethnicity to more-advantaged race/ethnicity was fluctuating and peaked in the year 2017 with an RD of 1.886, indicating a huge gap which then decreased gradually. Pairwise comparison showed that Non-Hispanic Whites and Non-Hispanic Blacks had RD greater than 0 and RR greater than 1 compared to Hispanics, indicating a higher incidence rate in both Non-Hispanic Whites and Non-Hispanic Blacks compared to Hispanics. While comparing rurality, metropolitan counties had higher age-adjusted incidence rates than non-metropolitan counties. The RD was less than 0 except in 2006, 2011, 2013, and 2014 when comparing metropolitans to non-metropolitans. Pairwise RR also showed similar results with RR less than 1 except in the above-mentioned years. Comparing based on median household income, those with higher income ($75,000+) had positive RD till 2016 than those with lower income (&lt;75,000) which then changed to negative from 2017 to 2020, which indicates an increase in incidence rates in the lower income group in the past few years. The pairwise ratio comparison also aligned, with a ratio above 1 most years which then turned to less than one after 2017. Racial rural-urban and socioeconomic disparities in incidence rates were evident in our study. Disparities have an impact on the incidence of pediatric neuroblastoma. Further exploration of the factors that lead to pediatric neuroblastoma disparities is required to reduce the gap.
Citation Format: Krishtee Napit, Emma Hymel, Josiane Kabayundo, Shinobu Watanabe-Galloway. Disparities in incidence rates of pediatric neuroblastoma in the United States: A Surveillance, Epidemiology, and End Results (SEER) Program Study using HD*Calc [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C096.