Global and Regional Trends in Paediatric Neuroblastoma Incidence and Mortality, 1990–2021: An Inequality and Projection Analysis

Neuroblastoma stands as the most prevalent extracranial solid tumour in children, yet its epidemiological profile on global, regional, and national scales remains insufficiently explored. Long-term trends in the incidence and mortality of paediatric neuroblastoma from 1990 to 2021 were analysed globally, regionally, and nationally using estimated annual percentage changes. Cross-national disparities in the burden of paediatric neuroblastoma were quantified through standard health equity methodologies, with projections of burden shifts extending to 2035. From 1990 to 2021, the global age-standardised death rate for paediatric neuroblastoma increased from 0.19 (95% UI, 0.16-0.23) to 0.21 (95% UI, 0.14-0.28) per 100 000 population, with an EAPC of 0.2. Regionally, both mortality and incidence rates were highest in low-middle SDI regions and lowest in Oceania. Mortality rates were highest among males aged 12-23 months and females aged 6-11 months, while incidence rates were most pronounced in children aged 2-4 years. Cross-country inequality analyses indicated a reduction in disparities between high and low SDI countries; however, the concentration index revealed an increase in the inequality of burden distribution. The global burden of paediatric neuroblastoma is projected to continue rising through 2035. Over the past 30 years, global incidence and mortality rates for paediatric neuroblastoma have risen, particularly in low-SDI regions, whereas high-SDI regions have witnessed a downward trend. Although disparities between high- and low-SDI countries have diminished, inequality in burden distribution has grown more pronounced. The global burden of paediatric neuroblastoma is expected to continue its upward trajectory over the next 15 years.