\documentclass[10pt]{article}

\usepackage{fullpage}
\usepackage{setspace}
\usepackage{parskip}
\usepackage{titlesec}
\usepackage[section]{placeins}
\usepackage{xcolor}
\usepackage{breakcites}
\usepackage{lineno}
\usepackage{hyphenat}





\PassOptionsToPackage{hyphens}{url}
\usepackage[colorlinks = true,
            linkcolor = blue,
            urlcolor  = blue,
            citecolor = blue,
            anchorcolor = blue]{hyperref}
\usepackage{etoolbox}
\makeatletter
\patchcmd\@combinedblfloats{\box\@outputbox}{\unvbox\@outputbox}{}{%
  \errmessage{\noexpand\@combinedblfloats could not be patched}%
}%
\makeatother


\usepackage{natbib}




\renewenvironment{abstract}
  {{\bfseries\noindent{\abstractname}\par\nobreak}\footnotesize}
  {\bigskip}

\titlespacing{\section}{0pt}{*3}{*1}
\titlespacing{\subsection}{0pt}{*2}{*0.5}
\titlespacing{\subsubsection}{0pt}{*1.5}{0pt}


\usepackage{authblk}


\usepackage{graphicx}
\usepackage[space]{grffile}
\usepackage{latexsym}
\usepackage{textcomp}
\usepackage{longtable}
\usepackage{tabulary}
\usepackage{booktabs,array,multirow}
\usepackage{amsfonts,amsmath,amssymb}
\providecommand\citet{\cite}
\providecommand\citep{\cite}
\providecommand\citealt{\cite}
% You can conditionalize code for latexml or normal latex using this.
\newif\iflatexml\latexmlfalse
\providecommand{\tightlist}{\setlength{\itemsep}{0pt}\setlength{\parskip}{0pt}}%

\AtBeginDocument{\DeclareGraphicsExtensions{.pdf,.PDF,.eps,.EPS,.png,.PNG,.tif,.TIF,.jpg,.JPG,.jpeg,.JPEG}}

\usepackage[utf8]{inputenc}
\usepackage[english]{babel}



\usepackage{float}








\begin{document}

\title{Prevalence of Acute Lymphoblastic Leukemia in the United States in
2017-2018: A SEER Study}



\author[1]{Shangyi Fu}%
\author[2]{Sofia Piperno}%
\author[3]{Danny Huynh}%
\affil[1]{Baylor College of Medicine School of Medicine}%
\affil[2]{The University of Texas Medical Branch at Galveston School of Medicine}%
\affil[3]{Teal Systems}%


\vspace{-1em}



  
  \date{May 20, 2024}


\begingroup
\let\center\flushleft
\let\endcenter\endflushleft
\maketitle
\endgroup








\sloppy


\textbf{Title: Prevalence of Acute Lymphoblastic Leukemia in the United
States in 2017-2018: A SEER Study}

\textbf{Authors:} Shangyi Fu BS\textsuperscript{1,2}, Sofia
Piperno\textsuperscript{3}, Danny Huynh BS\textsuperscript{3},

\textbf{Affiliations:}

\textsuperscript{1}School of Medicine, Baylor College of Medicine,
Houston, TX

\textsuperscript{2}Human Genome Sequencing Center, Baylor College of
Medicine, Houston, TX

\textsuperscript{3}School of Medicine, The University of Texas Medical
Branch, Galveston, TX

\textsuperscript{4}Embedded Systems Engineering, Teal Systems, Houston,
TX

\textbf{Corresponding Author:} Shangyi Fu B.S.\textsuperscript{1,2}, One
Baylor Plaza Houston, TX 77030, (832)484-8890, shangyi.fu@bcm.edu

\textbf{Declaration of Interest, Disclosures, Funding, and Conflict of
Interest:} None

\textbf{Abstract:}

Acute lymphoblastic leukemia (ALL) is part of a family of genetically
heterogeneous lymphoid neoplasms derived from B and T lymphoblasts. The
prevalence of ALL is typically diagnosed in childhood and its current
understanding is continuously expanding with time. With the event of
precision medicine, there is an increasing need to understand
socio-demographic patterns of disease development. In this letter, we
investigate the prevalence of ALL in the American population in relation
to age and race. Prevalence using the 2017-2018 SEER database found this
malignancy is most prominent in White race and between 10 and 24 in age.
This knowledge can be instrumental in expanding diagnoses and treatments
that account for sociodemographic factors.

\textbf{Keywords} : Acute lymphoblastic leukemia, malignancy, SEER,
cancer, sociodemographic determinants of health

\textbf{Prevalence of Acute Lymphoblastic Leukemia in the United States
using SEER}

\emph{To the Editor:} Acute Lymphoblastic Leukemia (ALL) is part of a
family of genetically heterogeneous lymphoid neoplasms derived from B
and T lymphoblasts {[}1{]}. The prevalence of ALL is reported to be
between 0.003\% to 0.004\% in 0--14-year-old and 0.001\% in those older
than 15 years old {[}2{]}. We aimed to estimate the prevalence of ALL
using the Surveillance, Epidemiology, and End Results (SEER) database,
an initiative by the National Cancer Institute.

As a retrospective study, this project did not need IRB approval. A
cross-sectional analysis using the SEER database was performed by
identifying patients with a diagnosis of primary ALL which corresponds
with the ICD10 code C91.0 and ICD9 code 204.00. The SEER database
corresponding with 2017-2018 has 43,926,825 enrolled participants (Table
1).

The estimated prevalence count for ALL is 10,163.5, representing an
overall prevalence of 0.02\% of Americans (Table 1). Prevalence in
specific racial groups included 0.02\% in white, 0.01\% in black, 0.01\%
in American Indian/Alaska native, and 0.01\% in Asian or pacific
islander patients. The prevalence was highest in the 10--24-year-old age
group (0.04\%), decreasing with age, which is in concordance to previous
data {[}3{]}.

In conclusion, this data shows that there is a higher prevalence of ALL
among White Americans that are children, adolescents, and young adults.
This analysis has limitations, namely among racial distribution. The
SEER database has a racial distribution of 54\% white, 12\% Black, 26\%
Hispanic, and 9\% Asian {[}4{]}, while the USA Census indicated that the
racial distribution of the country is 76\% White, 14\% Black, 19\%
Hispanic, and 6\% Asian {[}5{]}. This discrepancy shows that there might
be an underestimation of populations such as White and Black, and
overestimation of other populations, such as Hispanic and Asian.
Integrating this discrepancy shows that there should be an increase in
prevalence of White Americans afflicted by ALL that the data does not
account for.

\textbf{References}

1. Onciu M. Acute lymphoblastic leukemia. Hematol Oncol Clin North Am ,
2009 23: 655--674.

2. SEER Cancer Statistics Review, 1975-2018 {[}Internet{]}. SEER
{[}cited 2023 Mar 2{]} Available from:
https://seer.cancer.gov/csr/1975\_2018/index.html

3. Inaba H, Mullighan CG. Pediatric acute lymphoblastic leukemia.
Haematologica , 2020 105: 2524--2539.

4. Number of Persons by Race and Hispanic Ethnicity for SEER
Participants - SEER Registries {[}Internet{]}. SEER {[}cited 2023 Jan
28{]} Available from: https://seer.cancer.gov/registries/data.html

5. U.S. Census Bureau QuickFacts: United States {[}Internet{]}{[}cited
2023 Jan 24{]} Available from:
https://www.census.gov/quickfacts/fact/table/US/PST045222

\textbf{Hosted file}

\verb`Table 1 (1).docx`  available at \url{https://authorea.com/users/591941/articles/627691-prevalence-of-acute-lymphoblastic-leukemia-in-the-united-states-in-2017-2018-a-seer-study}

\selectlanguage{english}
\FloatBarrier
\end{document}

