The evolving burden of pediatric solid tumors: A global analysis from 1990 to 2021

To evaluate the global incidence and mortality trends of seven major solid tumors (brain cancer, hepatoblastoma, kidney cancer, malignant bone tumors [MNBAC], neuroblastoma, retinoblastoma, and soft tissue sarcomas) in individuals aged 0-19 years from 1990 to 2021.

Using data from the Global Burden of Disease Study 2021, analyses were stratified by age, region, and sociodemographic index (SDI). Temporal trends were quantified via estimated annual percentage change (EAPC). A linear regression model evaluated the correlation between childhood meningitis mortality and SDI.

In 2021, these tumors accounted for 96,913 new cases and 42,869 deaths worldwide. Brain cancer and MNBAC were the most common and fatal. Retinoblastoma showed the largest incidence increase, while neuroblastoma was the only tumor with rising mortality. Major regional disparities were observed, with East Asia having the highest brain cancer burden and sub-Saharan Africa experiencing the greatest retinoblastoma mortality. Incidence peaked in infants for hepatoblastoma, neuroblastoma, and soft tissue sarcomas, and in adolescents for bone tumors. Higher SDI correlated with higher neuroblastoma incidence, while lower-SDI regions had elevated mortality for multiple tumors.

Substantial global and regional disparities persist in the burden of pediatric solid tumors. Enhancing early detection in low-SDI regions and implementing targeted strategies for high-burden tumors such as brain cancer and MNBAC are essential to reducing mortality.