Global and Regional Trends in Paediatric Neuroblastoma Incidence and Mortality, 1990-2021: An Inequality and Projection Analysis.

Background: Neuroblastoma stands as the most prevalent extracranial solid tumour in children, yet its epidemiological profile on global, regional, and national scales remains insufficiently explored.

Methods: Long-term trends in the incidence and mortality of paediatric neuroblastoma from 1990 to 2021 were analysed globally, regionally, and nationally using estimated annual percentage changes. Cross-national disparities in the burden of paediatric neuroblastoma were quantified through standard health equity methodologies, with projections of burden shifts extending to 2035.

Results: From 1990 to 2021, the global age-standardised death rate for paediatric neuroblastoma increased from 0.19 (95% UI, 0.16-0.23) to 0.21 (95% UI, 0.14-0.28) per 100 000 population, with an EAPC of 0.2. Regionally, both mortality and incidence rates were highest in low-middle SDI regions and lowest in Oceania. Mortality rates were highest among males aged 12-23 months and females aged 6-11 months, while incidence rates were most pronounced in children aged 2-4 years. Cross-country inequality analyses indicated a reduction in disparities between high and low SDI countries; however, the concentration index revealed an increase in the inequality of burden distribution. The global burden of paediatric neuroblastoma is projected to continue rising through 2035.

Conclusions: Over the past 30 years, global incidence and mortality rates for paediatric neuroblastoma have risen, particularly in low-SDI regions, whereas high-SDI regions have witnessed a downward trend. Although disparities between high- and low-SDI countries have diminished, inequality in burden distribution has grown more pronounced. The global burden of paediatric neuroblastoma is expected to continue its upward trajectory over the next 15 years.