A new study demonstrated that pediatric cancer rates vary by U.S. state and geographic region, with the highest rates in the Northeast, specifically New Hampshire; Washington, DC; and New Jersey. The study findings were published in Morbidity and Mortality Weekly Report.

Researchers analyzed data from the U.S. Cancer Statistics report from 2003–2014 and identified 171,432 cases of pediatric cancers. The data are reported per 1 million people. They found the highest rates in the Northeastern United States (188.0 per 1 million) and lowest in the South (168.0). For specific states, the highest rates were in New Hampshire (205.5), Washington, DC (194.0), and New Jersey (192.3), whereas the lowest rates were in South Carolina (149.3) and Mississippi (145.2).

Several factors could influence the incidence rates, the researchers suggested. Different areas may contain different types of carcinogens (e.g., air pollution, secondhand smoke, food, drinking water, radiation). Genetic factors or race/ethnicity factors in certain populations could also be at play. Finally, in some areas higher incidence rates may be related to better access to care that improves detection.

The researchers cited the “extensive population-based surveillance data” that covered more than 99% of the U.S. population as a strength of their report and explained that the findings “can help cancer control planners and clinicians address obstacles in access to care, especially in states with large distances to pediatric oncology centers.”