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Trends in cancer incidence among children in the U.S
J G Gurney1, S Davis, R K Severson
1Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, Michigan, USA.
Insights
Childhood cancer incidence in the U.S. saw a modest yearly increase from 1974-1991, particularly in young children and specific cancer types like astroglial tumors and acute lymphoid leukemia.
Area of Science:
- Pediatric Oncology
- Cancer Epidemiology
- Public Health
Background:
- Analysis of temporal trends in childhood cancer incidence in the U.S.
- Stratification by age, sex, and race within common histologic subtypes.
Purpose of the Study:
- To analyze temporal trends in childhood cancer incidence.
- To identify trends across different age groups, sexes, and races.
- To examine trends within common histologic subtypes of childhood cancer.
Main Methods:
- Utilized population-based data from nine Surveillance, Epidemiology, and End Results (SEER) Program registries.
- Included over 12,000 children aged 14 years or younger diagnosed with malignant neoplasms between 1974 and 1991.
- Estimated average annual percentage change in incidence rates using Poisson regression.
Main Results:
- Overall childhood cancer incidence increased by 1% annually (1974-1991).
- Rates increased by 2% or more for astroglial tumors, rhabdomyosarcomas, germ cell tumors, and osteosarcomas.
- Increases were most pronounced in very young children (<3 years) and for specific cancers like retinoblastoma and neuroblastoma in infants.
Conclusions:
- Childhood cancer occurrence in specific histologies modestly increased in the U.S. from 1974 to 1991.
- These increases were most apparent among the youngest children.
- Findings highlight the need for continued surveillance and research into pediatric cancer trends.
Background:
This report provides results of an analysis of temporal trends in childhood cancer incidence in the U.S. stratfied by age, sex, and to a lessor extent, race, within common histologic subtypes.
Methods:
Population-based data from nine registries of the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute were analyzed. The analysis was limited to children age < or = 14 years. Cancer cases were restricted to those patients with a malignant neoplasm diagnosed between 1974 and 1991; more than 12,000 children were included. Average annual percentage change in incidence rates and corresponding 95% confidence intervals were estimated from the maximum likelihood method of Poisson regression.
Results:
Among children age < or = 14 years there was a 1% average yearly increase (95% CI 0.6, 1.3) in the incidence rates of all malignant neoplasms combined. The average annual percentage change was similar for males and females, and slightly higher for black children compared with white children. Rates increased an average of 2% or more per year for astroglial tumors, rhabdomyosarcomas, germ cell tumors, and osteosarcomas. The average annual percentage change for acute lymphoid leukemia was 1.6% and trends were somewhat stronger for blacks than whites. Cancer trends, in general, were strongest in young children. In particular, increases in astroglial tumors and rhabdomyosarcomas were most apparent among children age < 3 years, and for retinoblastoma and neuroblastoma among children in their first year of life. The average annual percentage change for acute lymphoid leukemia did not vary dramatically with age, however children age < 2 years had stronger trends compared with older children. We found little evidence for increasing trends in Wilms' tumor, primitive neuroectodermal tumors, or hematopoietic neoplasms other than acute lymphoid leukemia.
Conclusions:
These results suggest that cancer occurrence among children within specific histologies increased modestly in the U.S. between 1974 and 1991, and that the increases were most apparent among young children.