Population-based cross-sectional study of area-based marginalization and incidence of childhood cancer

Childhood cancer is a leading cause of disease-related mortality, with increasing incidence in many high-income countries. Socioecomic disparities in childhood cancer survival are well documented, but less is known about incidence. A population-based cross-sectional study in Ontario, a Canadian province with a universal health care system, identified pediatric cancer cases diagnosed from 1999 to 2023, among 2.3 million children aged 0 to 14 years. Of the 9063 pediatric cancer cases (55% male, median age at diagnosis 5 years, IQR 2-10), the age-standardized incidence rate was 162.7 cases per million (95% CI 159.3-166.1). Patients who lived in affluent neighborhoods had a 15% higher incidence rate of cancer compared with those in the least affluent areas (Q5 versus Q1: incidence rate ratio 1.15; 95% CI 1.01-1.16). The authors conclude that these findings suggest that factors associated with affluence may contribute to an increased risk of childhood cancer, highlighting the need to consider broader sociodemographic factors when examing pediatric cancer epidemiology.