Childhood cancer is becoming more common in the United States. Between 2003 and 2019, this incidence increased by half a percent each year, according to a recently published study by the Centers for Disease Control (CDC, our RIVM equivalent). Journal of the National Cancer Institute.
The researchers collected data from the USCS database, which covers more than 99% of the US population, to estimate age-adjusted incidence rates and trends in children and adolescents under 19 diagnosed with cancer during that period.
The results showed a cumulative cancer incidence of 178.3 per 1 million, with 248,749 cases reported during the period. Cancers with the highest incidence include leukemia (46.6), neoplasms of the central nervous system (30.8) and lymphoma (27.3). Among patients, the researchers found higher rates in males, children younger than 4, non-Hispanic white children and adolescents, and residents of the Northeast, counties in the top 25% of economic status, and least metropolitan counties. 1 million people.
The researchers looked at children who ranged in age from zero to 19 years old. They examined the period from 2003 to 2019 and looked at a few measures: Numbers, which is the number of cases; rate, which is the number of cases per 1 million people; and trends, which assess whether cancer is decreasing, increasing or staying the same. It took into account a few different variables, such as gender, age, race and ethnicity, geographic region, and cancer type.
Childhood cancer is still a rare occurrence, researchers say, but there has been a significant increase in several types, including leukemia, lymphoma, liver tumors, bone tumors and thyroid cancer. Brain tumors showed an interesting pattern: rates rose until 2017 and then declined.
David A. Siegel, MD, MPH, a pediatric hematologist/oncologist and commander of the United States Health Service Commissioned Corps, led the study. “There are many different reasons why trends in cancer incidence may increase or decrease,” he says. “A change in coding is one factor. How cancers are reported in these registries makes a difference. For example, the use of electronic pathology reporting has increased in recent decades. This makes it easier for pathologists to send information to cancer registries. Changes in diagnostic methods, such as how often doctors use MRIs to diagnose cancer, also change. All of these can affect certain trends.
He continues: “Risk factors can also change. For melanoma, for example, some public health interventions to reduce UV exposure may have contributed to the drop in rates. On the other hand, many studies have seen an increase in hepatoblastoma, a form of liver cancer. Certain risk factors for this cancer may have changed and contributed to the increase.
In addition, Siegel points out that childhood cancer survival rates are increasing and death rates are decreasing. “Therefore, cancer survivors are likely to be overrepresented, which is important because cancer survivors require long-term care. These questions are important for clinicians to keep in mind as they think about moving forward. These data provide context for designing clinical trials that will improve treatment outcomes and improve survival in the years to come.”
David A. Siegel, MD, MPH, et al., Childhood Cancer Counts, Incidence Rates, and Trends in the United States, 2003-2019. JNCI: Journal of the National Cancer Institute2023;, djad115, https://doi.org/10.1093/jnci/djad115
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