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Childhood cancer in Uruguay: 1992-1994. Incidence and mortality
L Castillo1, M Fluchel, A Dabezies
1Hospital Pereira Rossell, Bulevard Artigas 1550, Montevideo, Uruguay. lcast@adinet.com.uy
Insights
Childhood cancer incidence in Uruguay mirrors developed nations, but mortality rates are double. Improving cancer care outcomes for children in Uruguay presents a significant opportunity.
Area of Science:
- Pediatric Oncology
- Cancer Epidemiology
- Public Health
Background:
- Uruguay's centralized pediatric cancer care enables population-based incidence and mortality rate generation.
- This study addresses a gap in cancer data for developing countries in Latin America.
Purpose of the Study:
- To determine childhood cancer incidence and mortality rates in Uruguay.
- To compare these rates with international data.
- To identify opportunities for improving outcomes.
Main Methods:
- Incident childhood cancer cases (0-14 years) were identified from 1992-1994 using multiple data sources.
- Cancer diagnoses were classified using the International Classification of Childhood Cancer.
- Population data from national census records and follow-up until 1999 were used to calculate rates.
Main Results:
- The average annual incidence was 133.6 cases per million children.
- Cancer distribution was similar to industrialized nations, except for a higher rate and younger age group for Hodgkin lymphoma.
- The age-standardized childhood cancer mortality rate was 6.5 per 100,000, twice that of the US and Canada.
Conclusions:
- Uruguay's development indicators align more with Western nations than developing countries.
- Despite similarities in incidence, higher mortality rates highlight a need for improved pediatric cancer care.
- There is a clear opportunity to enhance outcomes for children with cancer in Uruguay.
Background:
The referral of all children with cancer in Uruguay to a single center affords the opportunity to generate population-based incidence and mortality rates in this developing country in Latin America.
Procedure:
All incident cases of cancer in children, 0-14 years of age, were ascertained from a combination of three sources for the period January 1992-December 1994. Diagnoses were grouped according to the International Classification of Childhood Cancer. Information on the size and age distribution of the total population was obtained from national census records. Follow-up was undertaken until December 1999 to afford a minimum interval of 5 years and the determination of mortality rates.
Results:
The average annual incidence was 133.6 cases of cancer per million children per year and the disease distribution was similar to that in industrialized countries, with the exception of a higher rate and younger age distribution for the Hodgkin disease. The overall age-standardized mortality rate from cancer in childhood, at 6.5 per 100,000, was approximately twice that in the United States and Canada.
Conclusions:
Basic indicators of development suggest that Uruguay is more akin to the countries of North America and Western Europe than to those in the developing world. An opportunity has been identified to improve the outcome for children with cancer in this country.