Overall survival of children and adolescents with cancer has improved significantly in recent decades, however,socioeconomic disparities persist, resulting in lower survival rates, especially in low- and middle-income countries, such as, in Brazil.

The aim of this study was to identify and analyze the spatial distribution of childhood cancer incidence and survival coefficients and verify their association with the Deprivation Index of a state in southeastern Brazil.

A retrospective observational study was held in 2023. We have obtained clinical and sociodemographic data through the Tumor Registration Form of the Hospital-based Cancer Registry of a reference hospital for pediatric oncology in Vitória, ES, located in the Southeast Region of Brazil. The cities of residence in the state at the time of diagnosis were geocoded using the Brazilian Deprivation Index (BDI). Overall survival was estimated using Cox regression adjusting for sex, age at diagnosis, histological group and stratified by each BDI quintile. 

The sample consisted of 865 new cases of pediatric neoplasms, with leukemias, Central Nervous System tumors and lymphomas being the most common. The estimated overall survival at 5 years was 61% (95%CI: 0.585-0.651; p=0.001) for children from the least disadvantaged city in the state. We observed a significant increase in the HR for death among children and adolescents in the most disadvantaged cities (Q5) (HR=2.12; 95%CI:1.06-4.23; p=0.034).

In summary, we observed that socioeconomic level estimated through the Brazilian Deprivation Index was associated with worse survival among children and adolescents with cancer. Socioeconomically disadvantaged children and adolescents can constitute a group of high-risk patients, who are identifiable at the time of diagnosis and can be targets of personalized interventions to be delivered in a timely manner.