Document Type

Capstone Experience

Graduation Date


Degree Name

Master of Public Health



First Committee Member

Shinobu, Watanabe-Galloway, PhD

Second Committee Member

Kendra, Ratnapradipa, PhD

Third Committee Member

Abraham, Mengist, PhD


In the United States (U.S.), 5-year survival for pediatric cancers improved from 58% in 1975 to 85% in 2017. However, pediatric cancer remains the second leading cause of death in children between 0 – 14 years. Despite the growing body of pediatric cancer research, there is limited knowledge of the urban and rural disparities of pediatric cancer mortality. This study examined: 1) the differences in the U.S. pediatric cancer mortality rates between rural and urban residents during 2016-2020 by demographic characteristics (age group, sex, race/ethnicity, and income) and cancer types and 2) the trend of pediatric cancer mortality in the U.S. from 2000 to 2020 by demographic characteristics and cancer types. Surveillance Epidemiology and End Results (SEER) 12 Incidence-Based Mortality Program data from 2000-2020 was used for the analysis. The primary exposure variable was rurality, classified according to the Rural-Urban Continuum Codes. The stratified analysis was conducted by demographic factors and cancer type. Joinpoint regression analysis was conducted to examine the time trend and annual percent change (APC). The mortality rate was similar for rural and urban residents regardless of demographic factors and cancer type. A declining trend in the overall mortality rate was observed from 2000 to 2020 (APC: -1.82%). However, urban areas had a steeper decline (APC: -1.83%) than rural areas (APC: -1.57%), and Non-Hispanic Whites (APC: -2.01%) and Hispanics (APC=-2.00%) also experienced a steeper decline than Non-Hispanic Blacks (APC: -1.21%). Understanding rural and racial disparities of pediatric cancer mortality can help guide clinical and public health interventions. Such interventions may ultimately improve the survival of pediatric cancer in the United States.

Available for download on Saturday, December 28, 2024

Included in

Public Health Commons