Trends in Childhood Cancer Incidence in the U.S. (1992–2004) pdf

Trends in Childhood Cancer Incidence in the U.S.

(1992–2004)

Amy M. Linabery, MS, MPH1

Julie A. Ross, PhD1,2

1 Division of Pediatric Epidemiology and Clinical

Research, Department of Pediatrics, University of

Minnesota, Minneapolis, Minnesota.

2 University of Minnesota Cancer Center, Minnea￾polis, Minnesota.

BACKGROUND. The etiology of most pediatric neoplasms remains elusive. Exami￾nation of population-based incidence data provides insight regarding etiology

among various demographic groups and may result in new hypotheses. The

objective of the current study was to present updated information regarding

childhood cancer incidence and trends in the U.S. overall and among demo￾graphic subgroups, including Asian/Pacific Islanders and Hispanics, for whom to

the authors’ knowledge trends have not been previously examined.

METHODS. Data obtained by 13 registries of the National Cancer Institute’s Surveil￾lance, Epidemiology, and End Results (SEER) program were evaluated to assess

incidence and trends of common primary cancers diagnosed between 1992 and

2004 among children aged birth to 19 years. Frequencies, age-adjusted incidence

rates, and joinpoint regression results, including annual percent change (APC) in

incidence rates (and 95% confidence intervals [95% CI]), were calculated.

RESULTS. Between 1992 and 2004, a modest, nonsignificant increase in the average

annual incidence rate (APC, 0.4%; 95% CI, 20.1%–0.8%) was observed for all pedi￾atric cancer diagnoses combined. There was a suggestion of an increase in leuke￾mia (APC, 0.7%; 95% CI, 20.1%–1.5%), and acute lymphoblastic leukemia in

particular (APC, 0.8%; 95% CI, 20.4%–1.9%), whereas rates for central nervous sys￾tem tumors overall were stable (APC, 20.1%; 95% CI, 21.1%–1.0%); 2 joinpoints

were observed for astrocytoma. Rate increases were noted for hepatoblastoma

(APC, 4.3%; 95% CI, 0.2%–8.7%) and melanoma (APC, 2.8%; 95% CI, 0.5%–5.1%).

Differences by demographic group (sex, age, and race/ethnicity) are also described.

CONCLUSIONS. The observed trends reinforce an ongoing need for population￾based surveillance and further etiologic studies. Cancer 2008;112:416–32.

2007 American Cancer Society.

KEYWORDS: epidemiology, childhood cancer, incidence, trends.

I

t is estimated that in 2007, approximately 10,400 U.S. children

aged birth to 14 years will develop cancer.1 There have been

ongoing public concerns regarding pediatric cancers,2–6 underscor￾ing a need to monitor incidence rates. The last comprehensive

reports concerning U.S. incidence trends included data through

19957,8; incidence statistics are publicly available in the National

Cancer Institute’s (NCI’s) annual Cancer Statistics Review (available

at URL: http://seer.cancer.gov/publications).9 Herein we provide

data regarding recent childhood cancer incidence and trends,

including an analysis of trends in several demographic groups.

MATERIALS AND METHODS

Data were obtained from the NCI’s Surveillance, Epidemiology, and

End Results (SEER) program.10 With an estimated 98% case

Address for reprints: Julie A. Ross, PhD, Depart￾ment of Pediatrics, University of Minnesota, 420

Delaware Street SE, MMC 422, Minneapolis, MN

55455; Fax: (612) 626-4842; E-mail: rossx014@

umn.edu

Supported by National Institutes of Health Grant

T32 CA099936 and the Children’s Cancer

Research Fund.

Received December 27, 2006; revision received

August 14, 2007; accepted August 16, 2007.

ª2007 American Cancer Society

DOI 10.1002/cncr.23169

Published online 11 December 2007 in Wiley InterScience (www.interscience.wiley.com).

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