Abstract 3556: Pediatric cancer in Puerto Rico: Epidemiologic trends and environmental risk context

Abstract Background: Pediatric cancer in Puerto Rico shows distinct patterns compared to the U.S., with Hispanic children experiencing disproportionate burdens. Previous observations indicate high rates of malignant epithelial neoplasms, most of which are thyroid cancers. Puerto Rico also contains numerous EPA Superfund and Toxic Release Inventory (TRI) sites that release IARC-classified carcinogens. This study integrates pediatric cancer epidemiology with regional environmental contamination to contextualize risk patterns. Methods: Pediatric cancer cases ages 0 to 18 diagnosed from 2009 to 2020 and pediatric thyroid cancer cases ages 0 to 20 diagnosed from 2000 to 2022, were obtained from the Puerto Rico Central Cancer Registry. Incidence, staging, and mortality patterns were described. Thyroid cancer case distribution was compared with the geographic placement of EPA Superfund and TRI facilities, and contaminant profiles were classified using IARC rankings. Results: Among 1,666 pediatric cancer cases diagnosed from 2009 to 2020, the most common cancers were leukemias (24.25%), malignant epithelial neoplasms (predominantly thyroid cancers) & melanomas (18.19%), and lymphomas (15.85%). CNS tumors (5.2 %) and leukemias (4.5%) had the highest mortality. Neuroblastoma and malignant bone tumors showed high rates of local and distant metastatic disease at diagnosis. Several cancer groups demonstrated positive annual percentage changes. From 2000 to 2022, 380 pediatric thyroid cancer cases were identified, with the highest proportions in the Northeast, North, and Central regions, which also contain clusters of Superfund and TRI facilities that release IARC Group 1 carcinogens such as PCBs and cadmium. Conclusion: Puerto Rico presents a distinct pediatric cancer profile, with thyroid cancer driving the high burden of malignant epithelial neoplasms and showing regional clustering near contaminated areas. These findings underscore the need to evaluate environmental exposures, diagnostic pathways, and structural determinants of pediatric cancer risk to support targeted interventions and enhanced surveillance. Citation Format: Celinés Rodríguez Acevedo, Gabriela Pardo, Lenulisy Rosado, MiaSara Pérez, Carolyn Ruiz, Karen Ortiz-Ortiz, Carlos R. Torres-Cintron, Ana Patricia Ortiz, Nancy Raquel Cardona, Rocío K. Rivera., . Pediatric cancer in Puerto Rico: Epidemiologic trends and environmental risk context [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 3556.