title: Urbanisation and incidence of acute lymphocytic leukaemia among United States children aged 0-4.
abstract: Acute lymphocytic leukaemia (ALL) incidence among children under 5 years of age was examined, utilising data from 24 United States cancer registries. County-based incidence rates among white children were compared across four levels of urbanisation: large and small metropolitan counties, and adjacent and nonadjacent rural counties. In metropolitan areas, the incidence of ALL was lower among blacks (rate ratio (RR)=0.38, confidence interval (CI)=0.33-0.44) and among Asians/Pacific Islanders (RR=0.78, CI=0.63-0.97) than among whites. Among white children, the incidence of ALL decreased across the four strata of urbanisation, from 67 to 62 to 65 to 54 cases per million person-years at-risk (two-sided trend P=0.009), such that rates were significantly lower in the most remote rural counties than in the most populous metropolitan counties (RR=0.80, 95% CI=0.70-0.91).
authors.affiliation: Department of Biostatistics, Bioinformatics and Epidemiology, Medical University of South Carolina, 135 Cannon Street, Charleston, SC 29425, USA. adelmaas@musc.edu
authors.forename: A S
authors.initials: AS
authors.lastname: Adelman
authors.forename: C C
authors.initials: CC
authors.lastname: McLaughlin
authors.forename: X-C
authors.initials: XC
authors.lastname: Wu
authors.forename: V W
authors.initials: VW
authors.lastname: Chen
authors.forename: F D
authors.initials: FD
authors.lastname: Groves
mesh_terms: D002675:Child, Preschool; D002947:Cities; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016017:Odds Ratio; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000453:epidemiology* / Q000209:etiology*; D012042:Registries / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D014505:Urban Population