Global disparities in childhood neuroblastoma: trends, burden, and inequities from 1990 to 2021

Rui Zhang; Yang Bi; Feifei Bao; Feixia Pan; Weize Xu; Qiang Shu; Zhigang Liu; Daqing Ma

doi:10.20892/j.issn.2095-3941.2025.0163

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Figure 1
Trends in the burden of childhood neuroblastoma from 1990 to 2021, stratified by gender and GBD region. The figure illustrates changes in incidence rates, DALYs, and death rates, and highlights disparities across regions and genders. DALYs refer to disability-adjusted life years.

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Table 1

Global burden of childhood neuroblastoma and other peripheral nervous system tumors from 1990 to 2021

Location	1990		2021		1990–2021
Location	Numbers	ASR	Numbers	ASR	EAPC
DALYs
Global	145,057.36 (120,924.76–173,294.3)	8.24 (6.84–9.91)	174,186.3 (127,104.64–223,265.92)	9.02 (6.44–11.68)	0.46 (0.36 to 0.56)
Low-middle SDI	32,911.41 (24,850–43,611.56)	6.71 (5.02–9.08)	54,242.65 (38,164.86–72,461.29)	9.75 (6.74–13.43)	1.54 (1.35 to 1.73)
Middle SDI	39,660.93 (32,221.61–46,615.78)	6.91 (5.54–8.31)	42,712.62 (31,748.88–53,985.24)	7.99 (5.89–10.3)	0.69 (0.46 to 0.92)
Low SDI	16,054.22 (10,755.5–24,982.99)	6.31 (4.14–9.86)	38,449.7 (20,758.04–61,655.36)	8.17 (4.36–13.2)	1.1 (0.68 to 1.52)
High SDI	30,823.93 (29,178.43–32,348.24)	17.04 (15.94–18.15)	19,471.08 (17,170.44–21,760.02)	11.78 (10.27–13.27)	−1.15 (−1.35 to −0.96)
High-middle SDI	25,479.35 (21,510.78–29,833.77)	9.5 (7.93–11.38)	19,178.88 (14,878.35–23,223.51)	8.77 (6.69–10.92)	−0.02 (−0.31 to 0.26)
GBD super regions
South Asia	31,073.6 (20,840.55–42,991.32)	6.97 (4.56–9.69)	50,618.87 (34,477.6–71,561.32)	10.87 (7.23–15.79)	1.73 (1.38 to 2.08)
Sub-Saharan Africa	18,474.94 (12,374.9–27,765.87)	7.37 (4.86–11.12)	46,946.49 (23,144.95–76,329.4)	9.59 (4.69–15.64)	1.2 (0.85 to 1.56)
Southeast Asia, East Asia, and Oceania	26,046.53 (19,386.44–34,334.12)	5.21 (3.81–7.04)	24,828.13 (18,692.86–30,506.92)	5.85 (4.31–7.39)	0.63 (0.41 to 0.85)
High-income	34,841.53 (33,230.73–36,355.63)	19.25 (18.2–20.39)	22,675.59 (19,866.84–25,516.33)	13.51 (11.65–15.38)	−1.06 (−1.24 to −0.89)
Latin America and Caribbean	18,014.48 (16,250.63–19,778.78)	12.65 (11.27–14.17)	15,413.84 (12,473.12–19,035.78)	11.06 (8.71–13.77)	−0.13 (−0.6 to 0.35)
North Africa and Middle East	8,735.94 (6,124.25–12,544.18)	6.05 (4–8.98)	9,986.29 (7,196.85–13,356.37)	5.55 (3.84–7.86)	0.09 (−0.16 to 0.34)
Central Europe, Eastern Europe, and Central Asia	7,870.35 (6,851.08–9,532.92)	7.57 (6.53–9.18)	3,717.09 (2,969.4–4,400.12)	4.81 (3.78–5.81)	−1.7 (−1.98 to −1.43)
YLL
Global	141,840.07 (118,398.48–169,250.1)	8.06 (6.67–9.69)	169,981.65 (123,925.12–217,945.87)	8.8 (6.28–11.44)	0.46 (0.35 to 0.56)
Low-middle SDI	32,298.92 (24,462.2–42,971.4)	6.59 (4.95–8.92)	53,082.84 (37,396.37–71,046.14)	9.54 (6.61–13.13)	1.53 (1.34 to 1.72)
Middle SDI	38,841.49 (31,568.29–45,666.25)	6.77 (5.42–8.13)	41,620.09 (30,992.42–52,622.83)	7.79 (5.77–10.04)	0.67 (0.44 to 0.9)
Low SDI	15,769.88 (10,546.04–24,639.25)	6.19 (4.06–9.72)	37,712.55 (20,377.48–60,738.31)	8.02 (4.28–12.99)	1.1 (0.68 to 1.52)
High SDI	29,938.89 (28,362.95–31,432.26)	16.55 (15.51–17.65)	18,831.35 (16,545.26–21,075.19)	11.4 (9.95–12.82)	−1.16 (−1.36 to −0.97)
High-middle SDI	24,866.3 (21,047.29–29,053.29)	9.28 (7.74–11.13)	18,606.64 (14,423.43–22,541.62)	8.51 (6.49–10.63)	−0.05 (−0.33 to 0.24)
GBD super regions
South Asia	30,510.59 (20,559.63–42,093.91)	6.84 (4.49–9.49)	49,553.69 (33,736.07–69,991.79)	10.64 (7.05–15.45)	1.72 (1.37 to 2.07)
Sub-Saharan Africa	18,137.67 (12,171.46–27,310.18)	7.24 (4.77–10.94)	46,000.58 (22,597.09–74,896.44)	9.4 (4.57–15.37)	1.19 (0.84 to 1.55)
Southeast Asia, East Asia, and Oceania	25,491.29 (18,927.73–33,546.19)	5.1 (3.73–6.86)	24,135.39 (18,212.09–29,658.63)	5.68 (4.2–7.19)	0.6 (0.38 to 0.83)
High-income	33,834.91 (32,351.27–35,347.88)	18.7 (17.66–19.81)	21,933.73 (19,192.95–24,809.7)	13.07 (11.27–14.89)	−1.07 (−1.25 to −0.9)
Latin America and Caribbean	17,634.88 (15,899.54–19,360.95)	12.38 (11.03–13.87)	15,029.07 (12,165.35–18,554.19)	10.78 (8.49–13.46)	−0.14 (−0.61 to 0.33)
North Africa and Middle East	8,549.55 (5,989.46–12,287.65)	5.92 (3.92–8.77)	9,714.25 (7,018.89–12,984.87)	5.4 (3.74–7.65)	0.07 (−0.18 to 0.32)
Central Europe, Eastern Europe, and Central Asia	7,681.18 (6,688.04–9,267.46)	7.38 (6.36–8.94)	3,614.94 (2,891.91–4,262.55)	4.68 (3.67–5.65)	−1.72 (−1.99 to −1.44)
YLD
Global	3,217.3 (1,998.41–4,852.01)	0.18 (0.11–0.28)	4,204.65 (2,551.19–6,643.59)	0.22 (0.13–0.35)	0.7 (0.59 to 0.81)
Low-middle SDI	612.49 (326.8–1,018.64)	0.13 (0.07–0.21)	1,159.81 (660.62–1,917.02)	0.21 (0.12–0.35)	2.01 (1.81 to 2.22)
Middle SDI	819.44 (478.35–1,310.49)	0.14 (0.08–0.23)	1,092.53 (676.19–1,694.09)	0.2 (0.12–0.32)	1.35 (1.1 to 1.6)
Low SDI	284.34 (139.16–532.25)	0.11 (0.05–0.21)	737.14 (329.95–1,420.7)	0.16 (0.07–0.3)	1.33 (0.86 to 1.81)
High SDI	885.05 (600.39–1,249.47)	0.49 (0.33–0.68)	639.73 (443.24–907.36)	0.39 (0.26–0.54)	−0.79 (−1.05 to −0.53)
High-middle SDI	613.05 (394.89–934.23)	0.23 (0.15–0.35)	572.24 (372.25–842.86)	0.26 (0.17–0.39)	0.74 (0.43 to 1.04)
GBD super regions
South Asia	563.01 (282.29–982.47)	0.13 (0.06–0.22)	1,065.18 (576.41–1,807.46)	0.23 (0.12–0.4)	2.26 (1.86 to 2.67)
Sub-Saharan Africa	337.27 (172.88–615.67)	0.13 (0.07–0.24)	945.91 (394.53–1,779)	0.19 (0.08–0.36)	1.5 (1.1 to 1.9)
Southeast Asia, East Asia, and Oceania	555.24 (315.08–906.24)	0.11 (0.06–0.19)	692.74 (432.97–1,043.75)	0.16 (0.1–0.24)	1.54 (1.3 to 1.78)
High-income	1,006.62 (684.1–1,417.38)	0.56 (0.37–0.78)	741.86 (514.99–1,050.93)	0.44 (0.3–0.63)	−0.75 (−0.97 to −0.52)
Latin America and Caribbean	379.59 (234.3–575.3)	0.27 (0.16–0.4)	384.78 (246.93–600.16)	0.28 (0.17–0.43)	0.38 (−0.16 to 0.91)
North Africa and Middle East	1,86.4 (101.51–321.31)	0.13 (0.07–0.23)	272.04 (164.12–430.98)	0.15 (0.09–0.25)	0.91 (0.62 to 1.19)
Central Europe, Eastern Europe, and Central Asia	189.16 (122.22–287.49)	0.18 (0.12–0.28)	102.15 (66.89–152.53)	0.13 (0.08–0.2)	−1.28 (−1.56 to −0.99)

This table summarizes key metrics, including age-standardized rates (ASR), estimated annual percentage changes (EAPC), and disability-adjusted life years (DALYs), further divided into years lived with disability (YLDs) and years of life lost (YLLs). The socio-demographic index (SDI) is included to contextualize findings across levels of development. Uncertainty intervals (UI) are presented for precision.