Socioeconomic variation in survival from childhood neuroblastoma in northern England: a population-based study

Background Few population-based studies have examined the influence of socioeconomic status (SES) on survival from childhood cancers, especially neuroblastic tumours (NT). This study investigated a possible association between SES and survival from NT in children diagnosed in northern England. Methods All 102 cases of NT, aged 0-14 years and diagnosed 1993-2014, were extracted from the population-based Northern Region Young Persons' Malignant Disease Registry. Kaplan-Meier estimation and Cox regression were used to analyse survival in relation to paternal SES and clinical characteristics. Results Survival differed between age-groups, with infants having the least risk of death. Increased risk of death was seen for children diagnosed with International Neuroblastoma Staging System stage 4 neuroblastoma compared to stage 1, 2, 3 and 4S (HR=6.8; 95% CI: 2.8-16.6), MYCN amplified versus non-amplified (Hazard Ratio (HR)=3.4; 95% CI: 1.7-6.8) and high risk versus low and intermediate risk cases (HR=9.1; 95% CI: 3.2-25.9). There were no differences between paternal SES, gender, site of primary tumour, or diagnostic period. Conclusions This study did not find a socio-economic effect on survival from NT diagnosed in northern England. This contrasts with other studies of NT elsewhere in the world where socioeconomic inequality has been shown to affect outcome.