Epidemiology of childhood cancer
Introduction
Cancer is the second commonest cause of death in children in the developed countries. Owing to highly specific diagnostic procedures and the introduction and continuous improvement of multimodal treatment strategies, the past decades have seen a welcome, marked rise in the probability of cure. Nevertheless, childhood cancer and its treatment have remained a challenge for patients, their families, and the oncologists caring for them, as well as from a public health viewpoint.
The present contribution provides information on the range of diagnoses, incidence and survival rates of childhood cancer as well as on time trends and geographical variation. The report draws mainly from findings generated in European cooperative projects where data from population-based cancer registries are pooled and are analyzed in a comprehensive manner.
Section snippets
Data sources
The data presented originate from different sources. Regarding Germany, this is the German Childhood Cancer Registry (GCCR), one of the largest pediatric cancer registries worldwide. The analyses pertaining to Europe have drawn from two cooperative projects, i.e. ACCIS and EUROCARE, where data from population-based cancer registries of European countries are merged. Data pertaining to the USA were obtained from the SEER program.
The German Childhood Cancer Registry (GCCR) was established at the
Diagnoses of childhood cancer
Table 2 gives the number of cases reported, percent values, median age, and sex ratio for each of the 12 main diagnostic groups and 47 diagnostic subgroups14 defined by ICCC-3. The leukemias (including myeloproliferative and myelodysplastic diseases) (34.1%), tumors of the central nervous system (CNS tumors, 22.6%), and lymphomas (including reticuloendothelial neoplasms) (11.5%) represent the largest diagnostic groups. The range of diagnoses is clearly different from the diagnoses seen in
Discussion
The incidence rate of cancer among children under 15 years of age is about 140 per million. Population-based cancer registries provide excellent means for observing the development in the cancer situation over extended periods of time. It is seen that the cancer incidence among children in the developed countries has risen steadily since the 1950s; this rise has been accompanied by a concurrent, marked improvement of prognosis. When changes like this are observed we are confronted with the
Conflict of interests
None declared.
Acknowledgements
The professional support by Susanna Siebert, GCCR, in producing the tables and figures and the scientific support by Claudia Spix, GCCR, are gratefully acknowledged. Special thanks to Eva Steliarova-Foucher (IARC), Lyon, who by her dedicated involvement in coordinating the ACCIS project has been instrumental in providing a reliable database on childhood cancer epidemiology in Europe. Many thanks as well to Gemma Gatta, Milano, for the childhood cancer specific analyses of the EUROCARE data. The
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