The incidence and epidemiologic characteristics of neuroblastoma in the United States.

The incidence of neuroblastoma in the United States is described in relation to age, sex, race, and anatomic site, as well as population-derived indicators of socioeconomic levels, degree of urbanization, and farming activity. Incidence data were obtained for the years 1973-1978 from the Surveillance, Epidemiology and End Results Program of the National Cancer Institute. Based upon 265 cases, the overall incidence of neuroblastoma was 2.26 per million person-years. Approximately 60% of the cases were diagnosed under age two years, 75% under age five years and 84% under age 10 years. The incidence among males was 1.3 times that among females, but the male predominance was observed only among persons diagnosed under age five years. Although no difference in overall incidence was observed by race, the rate among whites was 1.6 times that among blacks and 1.5 times that among other nonwhites under age five years. Approximately 50% of all cases were diagnosed with tumors arising from the adrenals or soft tissues. No clear pattern of area-to-area variation in incidence was identified. Neuroblastoma incidence was inversely related to socioeconomic level as measured by per capita income (p = 0.05), as well as the proportion of county land devoted to farming (p = 0.034). No association was observed in relation to urbanization or population density.