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Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies

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Area-Based Marginalization and Incidence of Childhood Cancer.

Maria Chiu^1,2, Felicia Leung¹, Jamie Rohde³

¹Pediatric Oncology Group of Ontario, Toronto, Ontario, Canada.

JAMA Network Open

|July 15, 2026

Summary

Childhood cancer incidence was higher in affluent neighborhoods, challenging previous assumptions about socioeconomic factors. This study highlights the need to explore the mechanisms behind these unexpected findings in pediatric cancer epidemiology.

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Area of Science:

Pediatric Oncology
Epidemiology
Public Health

Background:

Childhood cancer incidence is rising in high-income countries.
Socioeconomic disparities impact childhood cancer survival, but incidence data is limited.

Purpose of the Study:

To investigate the association between area-based deprivation and childhood cancer incidence.
To analyze these links within a universal healthcare system.

Main Methods:

Population-based cross-sectional study in Ontario, Canada (1999-2023).
Linked cancer registry data with socioeconomic data (Ontario Marginalization Index).
Analyzed 9063 pediatric cancer cases (ages 0-14) using multivariable Poisson regression.

Main Results:

Higher childhood cancer incidence rates were observed in less deprived areas (higher material resources and residential stability).
Incidence rate ratios were 1.15 for material resources and 1.08 for households/dwellings in the least vs. most marginalized quintiles.
These associations were primarily driven by hematologic and other solid cancer types.

Conclusions:

Contrary to expectations, affluent and residentially stable neighborhoods showed higher pediatric cancer incidence.
Sociodemographic factors are crucial in pediatric cancer epidemiology.
Further research is needed to understand underlying mechanisms and inform targeted strategies.