Characteristics and trends in incidence of childhood cancer in Beijing,China, 2000-2009

Objective： To investigate the characteristics and incidence trends of childhood cancer in Beijing, China, from 2000 to 2009. Methods： A total of 1,274 cases with childhood cancer in Beijing from 2000 to 2009 were included in the study. All rates were age-standardized using the direct method to the world standard population and expressed per million person-years. Incidence trends were characterized by calculating annual percent change （APC） usingJoinpoint Regression Program. Results： The crude incidence rate was 106.47 per million [age-standardized rate （ASR） 113.34] between 2000 and 2009 in Beijing with the most common diagnoses, leukemia （N=505, 39.64%, ASR 45.20）, followed by central nervous system （CNS） tumors （N=228, 17.90%, ASR 19.28） and lyrnphoma （N=91, 7.14%, ASR 6.97）. The incidence for all childhood cancers combined has increased during the study period, with an APC of 5.84% [95% confidence interval （95% CI）： 1.0-10.9] after adjusted by world population. The ASR of all combined cancers in boys showed a slight, but no significant increase, with an APC of 5.33 % （95 % CI： -0.6- 11.6）; for girls, the trends increased significantly, with an APC of 6.54% （95% CI： 1.5-11.8）. Conclusions： The incidence rate of childhood cancer in Beijing was higher than the average level of China and lower than that of western countries. The incidence trends of childhood cancer, especially leukemia among girls showed a significantly increase from 2000 to 2009. While among boys, no substantially change was seen during the observed time period. Some sex-specific trends by subcategories and trends of major cancers in different age groups by cancer site merit further investigation.     

Trends in childhood cancer incidence and mortality in Catalonia, Spain, 1975-1998.

Childhood cancer mortality has sharply declined in most economically developed countries over the last years, whereas no substantial changes in the incidence have been observed. In Catalonia (Spain), childhood cancer mortality showed a considerable decline until 1992, but incidence trends have not been analysed in this population. To assess both recent incidence and mortality trends in this population, we analysed childhood (0-14 years) cancer data from the population-based Tarragona Cancer Registry and from the Mortality Registry of Catalonia (Spain) from 1980 to 1998. All cancer mortality decreased by -2.6% annually in boys (95% confidence interval, 95% CI -3.7, -1.6) and -3.7% in girls (95% CI -4.9, -2.5). Mortality due to leukaemia decreased annually -3.0% in boys (95% CI -4.7, -1.4) and -4.4% in girls (95% CI -6.3, -2.4). Mortality for brain tumours showed a reduction of -3.2% in boys (95% CI -5.5, -0.9) and of -4.4% in girls (95% CI -6.3, -2.4). No significant trend in incidence rates, either in boys or in girls, was observed (annual per cent of change for all cancers -0.5%, 95% CI -3.5, 2.7, in boys and 1.7%, 95% CI -1.9, 5.5, in girls). These results suggest an improvement in both childhood cancer diagnosis and treatment, which may explain current higher childhood cancer survival rates.     

Trends in childhood leukemia incidence over two decades from 1992 to 2013

Incidence rates of childhood leukemia in the United States have steadily increased over the last several decades, but only recently have disparities in the increase in incidence been recognized. In the current analysis, Surveillance, Epidemiology and End Results (SEER) data were used to evaluate recent trends in the incidence of childhood leukemia diagnosed at age 0–19 years from 1992 to 2013, overall and by age, race/ethnicity, gender and histologic subtype. Hispanic White children were more likely than non‐Hispanic White, non‐Hispanic Black or non‐Hispanic Asian children to be diagnosed with acute lymphocytic leukemia (ALL) from 2009 to 2013. From 1992 to 2013, a significant increase in ALL incidence was observed for Hispanic White children [annual percent change (APC)_Hispanic = 1.08, 95% CI: 0.59, 1.58]; no significant increase was observed for non‐Hispanic White, Black or Asian children. ALL incidence increased by about 3% per year from 1992 to 2013 for Hispanic White children diagnosed from 15 to 19 years (APC = 2.67; 95% CI: 0.88, 4.49) and by 2% for those 10–14 years (APC = 2.09; 95% CI: 0.57, 3.63), while no significant increases in incidence were observed in non‐Hispanic White, Black, or Asian children of the same age. Acute myeloid leukemia (AML) incidence increased among non‐Hispanic White children under 1 year at diagnosis, and among Hispanic White children diagnosed at age 1–4. The increase in incidence rates of childhood ALL appears to be driven by rising rates in older Hispanic children (10–14, and 15–19 years). Future studies are needed to evaluate reasons for the increase in ALL among older Hispanic children.     

Trends in Incidence of Childhood Lymphoma in Khon Kaen,Thailand, 1985-2008

Background: Lymphoma is the second most common of childhood cancer in Thailand, but data on trendsover time are limited. Objective: To perform a statistic assessment of the incidence trend of childhood lymphomain Khon Kaen, Thailand, between 1985 and 2008. Method: All children aged < 15 years newly diagnosed withlymphoma according to International Childhood Cancer Classification (ICCC) during January 1, 1985- December31, 2008 were collected from data base of Khon Kaen Provincial Registry. Aged-adjusted incidence rates (ASRs)were calculated by standard method and trends were calculated using the generalized linear model method, which utilizes incidence-rate-base logarithms. Results: During 1985-2008 there were 72 children (47boys and 25 girls) who were diagnosed with lymphoma in Khon Kaen province. The peak age-group of diseasewas in the 5-9 year olds for both sexes. All cases were pathologically proven. Non-Hodgkin lymphoma (NHL)was more common than Hodgkin disease (ratio 7:1). The overall ASR was 6.04 per million (95%CI: 4.64 to 7.45)and the ASR was 7.64 per million (95%CI: 5.44 to 9.84) in boys and 4.37 per million (95%CI: 2.64 to 6.10) ingirls. Significant increases were observed for boys, since the 2006 to 2008 ASR was 15.3 per million (95%CI:5.73 to 25.0). Trend analyses during 1985 - 2008 showed that incidence among boys for lymphoma increasedby 1.38 percent per year (95%CI:- 4.6-8.3) while the incidence among girl decreased by 2.6 percent per year(95%CI:- 12-6.8). Conclusions: Our data showed that the incidence of childhood lymphoma in Khon Kaenprovince was similar to the one of Thailand but lower than those of western countries. During the past 24 years,the incidence trend seems to be increasing in boys but decreasing in girls. Interpretation is difficult without abetter understanding of what underlies the reported changes.     

Childhood leukemia incidence in Britain, 1974-2000: time trends and possible relation to influenza epidemics

Time trends in incidence of disease may cast light on etiology. We investigated time trends in childhood leukemia by using Poisson regression methods to analyze data from the National Registry of Childhood Tumours, a long-standing high-quality registry that covers the whole childhood population of Britain. During 1974-2000, the average annual percentage change in rate (AAC) of childhood acute lymphoblastic leukemia (ALL) in Britain was 0.7% (95% confidence interval [CI] = 0.4 to 1.0). This increase was apparently driven by the "common" subtype (expressing the CD10 antigen) of precursor B-cell ALL, for which the estimated AAC during 1980-1996 was 1.4% (95% CI = 0.8 to 2.0). There was no statistically significant time trend in other subtypes of ALL combined (1980-1996) or in acute myeloid leukemia (1974-2000). Small peaks in incidence of ALL in 1976 and 1990 coincided with years immediately following influenza epidemics. These results are consistent with hypotheses that some childhood leukemia may be triggered by infection occurring close to the time of diagnosis of leukemia, particularly in conditions of low herd immunity, and raise the possibility that contact with influenza shortly before the diagnosis of leukemia may sometimes be involved.     

Liver cancer in European children: incidence and survival, 1978-1997. Report from the Automated Childhood Cancer Information System project

Data on 849 children diagnosed with malignant hepatic tumours (International Classification of Childhood Cancer, Group VII) before the age of 15 years during 1978-1997 in Europe were extracted from the ACCIS database. Age-standardised incidence during 1988-1997 was 1.5 per million overall, 1.2 per million for hepatoblastoma and 0.2 per million for hepatic carcinoma. Over 90% of cases of hepatoblastoma occurred before age 5 years, whereas hepatic carcinoma had a fairly flat age distribution. Both tumours had an incidence in boys of 1.5-1.6 times that in girls. There were no significant time trends in incidence during 1978-1997. Five-year survival from hepatoblastoma diagnosed during 1988-1997 was 63% overall, and ranged from 52% in Eastern Europe to 84% in the North. Survival from hepatic carcinoma was much lower (37%). Between 1978-1982 and 1993-1997, 5-year survival (95% confidence interval (95% CI)) increased from 28% (95% CI 18-39) to 66% (95% CI 55-74) for hepatoblastoma and from 17% (95% CI 6-33) to 50% (95% CI 26-70) for hepatic carcinoma. These increases reflect the impact of advances in treatment of childhood liver cancer at a population level.     

Increasing incidence of childhood leukemia in Northwest Italy, 1975-98

Although some childhood cancer registries reported increasing incidence, the evidence and magnitude of time trends in the incidence of childhood leukemia are debated and the scientific evidence is conflicting. Only limited data have so far been supplied from Southern European countries. We present an analysis of the incidence trend of childhood leukemia in Piedmont (NW Italy) in 1975-98, based on data from the population-based childhood cancer registry. The Childhood Cancer Registry of Piedmont has been recording cases of childhood neoplasms since 1967. Procedures have been uniform and are based on an active search for cases and relevant information. Only cases with confirmed residence in Piedmont at diagnosis are included. Eight hundred cases of leukemia (622 acute lymphoblastic [ALL], 133 acute nonlymphoblastic [AnLL], 45 other and unspecified) were recorded in the period 1975-98 considered in our study. Incidence trends were analyzed using piecewise regression and Poisson regression, based on annual incidence rates. As results from the 2 analyses were similar, only the former were reported. In the age group 1-4 years, a statistically significant annual 2.6% increase in incidence rate of ALL (adjusted by age and gender; 95% confidence interval [CI] 1.13-4.13) was estimated. There was no evidence of increase in other age groups. During 1980-98, a statistically significant 4.4% annual increase (95% CI 1.86-6.90) was seen for pre-B-All in the age group 1-4 years. An increase was also seen for T-ALL that was not statistically significant. Sensitivity analyses were conducted, with no relevant differences from the main results. Our data suggest an increasing trend in ALL incidence for children between the ages of 1 and 4 years. These results are unlikely to be explained by changes in quality of data or exhaustiveness in reporting in the study period. The results were not changed in the sensitivity analyses we conducted. Possible causes to be investigated include environmental factors, changes in family size and parental age, socioeconomic conditions and geographical distribution of cases.     

Effects of maternal age and cohort of birth on incidence time trends of childhood acute lymphoblastic leukemia.

Several studies report increasing trends in the incidence of childhood acute lymphoblastic leukemia (ALL). Because ALL may generate in utero, this study investigated if maternal age and birth cohort influence ALL temporal trends. Data on 252 ALL cases in children ages 1 to 5 years were extracted from the population-based Childhood Cancer Registry of Piedmont, Italy. Information on cases' maternal age and year of birth was obtained from the registry, whereas population data were obtained for children born in 1980 to 1997. Incidence rates were analyzed using an age-period-cohort approach, in which the period effect was represented by the child year of birth, the age effect by the maternal age at the time of delivery, and the cohort effect by the maternal birth cohort. ALL incidence increased over the study period [annual percentage change 2.49%; 95% confidence interval (95% CI), 0.09-4.93]. A linear effect of the maternal time variables (P = 0.012) was found, which was equally described by maternal age (direct association) and maternal birth cohort (inverse association). The annual percentage change was 1.83% (95% CI, -0.59-4.31), when maternal age was included in the model, and 5.72% (95% CI, 2.29-9.27), when maternal year of birth was included. In conclusion, maternal characteristics substantially affect temporal trends in childhood ALL incidence.     

Trends in Incidence of Childhood Leukemia,Khon Kaen,Thailand, 1985-2002

Background: The Khon Kaen Cancer Registry (KKCR), providing both hospital and population-based ‍registration, was established in 1984 in the Faculty of Medicine, Khon Kaen University. Leukemia is the most ‍common cancer among Thai children in Thailand, including both curable and preventable types, but no assessment ‍of trends has hitherto been performed. Objective: To perform a statistical assessment of the incidence trend of ‍childhood leukemia in Khon Kaen, Thailand, between 1985 and 2002. Methods: Population-based cases of childhood ‍leukemia registered between 1985 and 2002 were retrieved from the KKCR and cases with an ICD-O diagnosis ‍(coding C42) in children under 15 were selected. Incidence trends were calculated using the Generalized Linear ‍Model method (GLM), which generates incidence-rate-based logarithms. Results: Of the 277 cases of leukemia, ‍boys were affected two times more frequently than girls and half of the cases were 0-4 years of age. Most diagnoses ‍were histologically- or cytologically-proven and the most common type (affecting two-thirds, 65.7%) was acute ‍lymphoblastic leukemia (ALL). The overall, age-standardized rate (ASR) for leukemia was 31.9 per million (95%CI: ‍28.1 to 35.7); 40.3 per million (95%CI: 34.2 to 46.4) in boys and 27.0 (95%CI: 21.8 to 32.2) in girls. Incidence has ‍been increasing by 2.4% per year in boys (95% CI: -0.5 to 5.3) and 4.1% per year in girls (95% CI: 1.1 to 7.2). ‍Conclusions: This incidence-rate-based logarithm indicates that childhood leukemia has been increasing, suggesting ‍further epidemiological research on causes and possible prevention is needed.     

Trends in childhood cancer incidence in the U.S. (1992-2004)

BACKGROUND: The etiology of most pediatric neoplasms remains elusive. Examination 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 demographic 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 Surveillance, 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, -0.1%-0.8%) was observed for all pediatric cancer diagnoses combined. There was a suggestion of an increase in leukemia (APC, 0.7%; 95% CI, -0.1%-1.5%), and acute lymphoblastic leukemia in particular (APC, 0.8%; 95% CI, -0.4%-1.9%), whereas rates for central nervous system tumors overall were stable (APC, -0.1%; 95% CI, -1.1%-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.     

Trend analysis of cancer incidence in Japan using data from selected population-based cancer registries

Population-based cancer registries are operated by over 80% of prefectures in Japan. However, only a limited proportion of the registries can provide long-term incidence data. Here, we aimed to establish a method for monitoring cancer incidence trends in Japan using data from selected prefectures. Based on the availability of long-term (≥ 20 years) high-quality data, we collected incidence data from five prefectures (Miyagi, Yamagata, Fukui, Osaka, and Nagasaki), which included an annual average of 54,539 primary cancer cases diagnosed between 1985 and 2004. Cancer mortality data for 1995-2004 were obtained from the vital statistics. Representativeness and homogeneity of the trends were examined by funnel plot analysis of log-linear regression coefficients calculated for the most recent 10 years of data (1995-2004) of age-standardized rates (ASR). The ASR of incidence for five prefectures in total (5-pref total) showed a significant decrease, with an annual percent change (APC) of -1.0 (95% confidence interval [CI] -1.4: -0.6) for males and -0.4 (95% CI -0.8: -0.1) for females. Excluding data from Osaka (4-pref total) reversed the decreasing trend; the corresponding APC was +0.4 (95% CI -0.2: +1.0) for males and +0.7 (95% CI +0.5: +0.9) for females. The APCs for the ASR of mortality for the 4-pref total (males, -1.5; females, -1.3) were more representative of nationwide data (males, -1.4 [95% CI -1.7: -1.2]; females, -1.1 [95% CI -1.4: -0.9]) than those for the 5-pref total (males, -1.7; females, -1.4). We conclude that using data from Miyagi, Yamagata, Fukui, and Nagasaki prefectures, with continuous monitoring of the representativeness of the data, is a provisionally relevant way to evaluate cancer incidence trends in Japan.     

Trends in the incidence of cancer in the Sousse region,Tunisia, 1993–2006

In this article, we analyzed trends in incidence rates of the major cancer sites for a 14‐year period, 1993–2006, in the Sousse region localized in the centre of Tunisia. Five‐year age‐specific rates, crude incidence rates (CR), world age‐standardized rates (ASR), percent change (PC) and annual percent change (APC) were calculated using annual data on population size and its estimated age structure. A total of 6,975 incident cases of cancer were registered, with a male to‐female sex ratio of 1.4:1. ASRs showed stable trends (?0.1% in males, and +1.0% in females). The leading cancer sites in rank were lung, breast, lymphoma, colon‐rectum, bladder, prostate, leukemia, stomach and cervix uteri. For males, the incidence rates of lung, bladder and prostate cancers remained stable over time. While, cancers of colon‐rectum showed a marked increase in incidence (APC: +4.8%; 95% CI: 1.2%, 8.4%) and non‐Hodgkin's lymphoma (NHL) showed a notable decline (APC: ?4.4%; 95% CI: ?8.2, ?0.6). For females, cancers of the breast (APC: +2.2%; 95% CI: 0.4%, 4.0%) and corpus uteri (APC: +7.4%; 95% CI: 2.8%, 12.0%) showed a marked increase in incidence during the study period, while the cervix uteri cancer decreased significantly (APC: ?6.1%; 95% CI: ?9.2%, ?3.0%). The results underline the increasing importance of cancer as a cause of mortality and morbidity in Tunisia. Our findings justify the need to develop effective program aiming at the control and prevention of the spread of cancer amongst Tunisian population.     

Higher risk for acute childhood lymphoblastic leukaemia in Swedish population centres 1973-94. Swedish Child Leukaemia Group.

A population-based sample of acute childhood leukaemia cases in Sweden 1973-94 was analysed by a geographical information system (GIS) for spatial leukaemia distribution in relation to population density. The annual incidence rate for acute lymphoblastic leukaemia (ALL) was 3.6, and for acute non-lymphoblastic leukaemia (ANLL) 0.7, cases per 100,000 children. Incidence rates in population centres, constituting 1.3% of Sweden's land area and approximately 80% of the population, compared with the rest of Sweden showed a statistically significant excess of ALL [odds ratio (OR) 1.68; 95% confidence interval (CI) 1.44-1.95], but not ANLL (OR 1.13; 95% CI 0.98-1.32). An increasing trend, however not statistically significant, was found for ALL incidence with both increasing population density in parishes and increasing degree of urbanity in municipalities. These findings support the theories that some environmental factors associated with high population density, such as infectious agents, may be of aetiological importance for childhood acute lymphoblastic leukaemia.     

Incidence Trend for Non-Hodgkin Lymphoma in the North Tunisian Population, 1998-2009

Background: In 2008, non-Hodgkin lymphoma ranked tenth among other malignancies worldwide with an incidence of around 5 cases per 100,000 in both genders. The latest available rates in Tunisia are from 2006. Materials and Methods: This study aimed to provide an update about NHL incidence for 2009 and its trend between 1998 and 2009 as well as a projection until 2024, using data from the Salah Azaiz Institute hospital registry and the Noth Tunisia cancer registry. Results: In 2009, the NHL incidence in the north of Tunisia was 4.03 cases per 100,000, 4.97 for men and 3.10 for women. Diffuse large B-cell lymphoma (DLBCL) accounted for 63.2% of all NHL subtypes. Between 1998 and 2009, the overall trend showed no significant change. When we compared the trend between two periods (1998-2005 and 2005-2009), joinpoint regression showed a significant decrease of NHL incidence in the first period with an annual percentage change (APC) of -6.7% (95% CI:[-11.2%;-2%]), then the incidence significantly increased from 2005 to 2009 with an APC of 30.5% (95% CI: [16.1%; 46.6%]. The analyses of the different subtype trends showed a significant decrease in DLBCL incidence between 1998 and 2000 (APC:-21.5; 95% CI: [-31.4%;-10.2%]) then the incidence significantly increased between 2004 and 2007 (APC: 18.5; 95% CI: [3,6%;35.5%]). Joint point analysis of the age-period-cohort model projection showed a significant increase between 2002 and 2024 with an APC of 4.5% (%95 CI: [1.5%; 7.5%]). The estimated ASR for 2024 was 4.55/100 000 (95% CI: [3.37; 6.15]). Conclusions: This study revealed an overall steady trend in the incidence of NHL in northern Tunisia between 1998 and 2009. Projection showed an increase in the incidence in NHL in both genders which draw the attention to the national and worldwide burden of this malignancy.     

Trends in urinary bladder cancer incidence in Sweden 1960-93 with special reference to histopathology, time period, birth cohort, and smoking

This study investigates the incidence trends of urinary bladdercancer in Sweden from 1960 through 1993 (a total of 46,211 cases).Age-standardized incidence rates increased among men from 14.6 per 10 5 in1960 to 33.5 in 1993 and among women from4.8 to 8.8, corresponding to anaverage annual increase of 2.4 percent (95 percent confidence interval [CI])= 2.0-2.7 percent) and 1.1 percent (CI = 0.9-1.4 percent), respectively. Thelargest increase occurred in the oldest age-groups. The proportion ofpatients with transitional cell carcinoma increased in menfrom66.0 percent in1960-64 to 93.6 percent in 1990-93 and in women from 61.0 percent to 89.4percent. The proportion of patients with papillomas decreased, whereas thosewith adenocarcinoma and squamous cell carcinoma were stable. Regressionmodeling (based on the period 1960-89) showed a strong linear effect due toeither period and/or cohort. Among men, additional non-linear effects by bothperiod and cohort were obtained. T he cohort effects were more important.Cohort data on having smoked daily showed considerable similarities with theestimated cohort-effects. Our findings suggest that the increase of tobaccosmoking in successive generations can explain the increase in incidence ratesof bladder cancer in Sweden, whereas improved diagnostic activities andregistration are less likely to explain fully the changes in incidence rates.     

A record-linkage study of the development of hepatocellular carcinoma in persons with hepatitis C infection in Scotland

We investigated trends in first-time hospital admissions and deaths attributable to hepatocellular carcinoma (HCC) in a large population-based cohort of 22 073 individuals diagnosed with hepatitis C viral (HCV) infection through laboratory testing in Scotland in 1991-2006. We identified new cases of HCC through record-linkage to the national inpatient hospital discharge database and deaths registry. A total of 172 persons diagnosed with HCV were admitted to hospital or died with first-time mention of HCC. Hepatocellular carcinoma incidence increased between 1996 and 2006 (average annual change of 6.1, 95% confidence interval (CI): 0.9-11.6%, P=0.021). The adjusted relative risk of HCC was greater for males (hazard ratio=2.7, 95% CI: 1.7-4.2), for those aged 60 years or older (hazard ratio=2.7, 95% CI: 1.9-4.1) compared with 50-59 years, and for those with a previous alcohol-related hospital admission (hazard ratio=2.5, 95% CI: 1.7-3.7). The risk of individuals diagnosed with HCV developing HCC was greatly increased compared with the general Scottish population (standardised incidence ratio=127, 95% CI: 102-156). Owing to the advancing age of the Scottish HCV-diagnosed population, the annual number of HCC cases is projected to increase, with a consequent increasing burden on the public healthcare system.     

江苏省昆山市2006~2015年膀胱癌发病趋势分析

[目的]分析江苏省昆山市2006～2015年膀胱癌的发病趋势.[方法]2006～2015年膀胱癌发病病例来源于昆山市肿瘤登记报告;计算历年膀胱癌粗发病率与年龄标化发病率(中标发病率).用平均年度变化百分比(APC)及其95％CI评价膀胱癌发病率在年份之间的变化趋势;用时间趋势与自回归模型结合的方法预测未来年份膀胱癌粗发病率.[结果] 2006～2015年登记膀胱癌519例,占同期新发恶性肿瘤的2.12％.膀胱癌中标发病率在男女合计(APC=1.6％,95％CI:-0.6％～3.8％)、男性(APC=1.3％,95％CI:-1.2％～3.8％)和女性(APC=5.3％,95％CI:-2.1％～12.7％)无明显趋势变化;但30～69岁人群膀胱癌中标发病率变化趋势在男女合计(APC =4.1％,95％CI:0.5％～7.7％)和女性(APC=9.5％,95％CI:1.0％～18.0％)人群中明显上升.时间趋势与自回归模型预测结果显示2016～2020年膀胱癌粗发病率在男性和女性人群中均呈现持续上升趋势.[结论]虽然膀胱癌中标发病率无明显趋势变化,但是膀胱癌发病数逐年增加,因膀胱癌造成的疾病负担逐年增加,特别在30～69岁女性人群中上升趋势最为显著.     

Increased incidence rates but no space-time clustering of childhood astrocytoma in Sweden, 1973-1992: a population-based study of pediatric brain tumors

BACKGROUND: Incidence patterns, trends, and spatial and/or temporal clustering of childhood brain tumors were analyzed in the population-based national cancer registry of Sweden. METHODS: Temporal trends were analyzed by a logistic regression procedure in which the average annual percentages of change in incidence rates and the corresponding 95% confidence intervals (CIs) were calculated. Spatial and/or temporal clustering were investigated by using a geographic information system and analyzed with a modified version of the Knox test and a spatial scan statistic. RESULTS: Primary brain tumors in 1223 children ages 0-15 years were registered during 1973-1992. In 80% of cases, the tumor was classified as malignant. Conclusive histopathology was classified in 1142 cases. The age-adjusted incidence rate for all subtypes of brain tumors was 35.9 cases per million children, and for malignant brain tumors 28.6. A statistically significant increasing temporal trend was observed for the group of malignant brain tumors as a whole (P=0.0001) and the astrocytoma subgroup (P=0.0001). The annual average increases were 2.6% (95% CI=1.5-3.8) and 3.0%, respectively (95% CI=1.6-4.4). The increase in astrocytoma cases was significantly larger for girls than for boys (P=0.021) and was most striking for girls ages 6-15 years, with an annual average increase of 4.7%. Rates had not increased for the primitive neuroectodermal tumor (PNET)/medulloblastoma or ependymoma subgroups. The geographic distribution of astrocytoma cases was homogenous. No statistically significant space-time interaction or local clusters in space and/or time were found for astrocytomas only or when astrocytomas were grouped with PNETs/medulloblastomas and ependymomas. CONCLUSIONS: The results show statistically increased incidence rates of childhood astroglial tumors, predominantly for girls, in Sweden during the period 1973-1992, but no clustering in space or time.     

Increasing incidence rates of childhood malignant diseases in Sweden during the period 1960-1998

We analysed the trends in incidence rates of childhood cancer in Sweden. All cases of malignant diseases and benign brain tumours in children, 0-14 years old, reported to the Swedish Cancer Registry 1960 to 1998 were included, n=9298. Cases were classified according to the International Classification of Childhood Cancer. Average annual change in incidence rate was calculated to +1.01%, (95% confidence interval CI=0.80, 1.22). An increase in incidence rate per year was found for leukaemia, +0.85% (95% CI=0.42, 1.28), lymphomas +1.87% (95% CI=1.17, 2.58), CNS (central nervous system) tumours +1.45% (95% CI=1.02, 1.88), sympathetic nervous system tumours +1.61% (95% CI=0.79, 2.44), hepatic tumours +2.62% (95% CI=2.02, 3.21), and germ cell and gonadal tumours +1.21% (95% CI=0.23, 2.19). Of the CNS tumours, significant changes were seen for low-grade glioma/astrocytoma +2.10% (95% CI=1.41, 2.80), benign brain tumours +3.77% (95% CI=2.47, 5.10), and PNET/medulloblastoma +1.96% (95% CI=0.48, 3.46). Changes in diagnostic criteria and better diagnostic tools may have contributed to these results.     

Life expectancy as an indicator of outcome in follow-up of population-based cancer registries: the example of childhood leukemia.

BACKGROUND: Survival analysis is a standard methodology to assess progress in oncology disease treatment. However, survival analysis commonly only measures survival during the treatment period (and the period immediately afterwards), and does not provide an estimate of life expectancy, which is often of more interest to patients and to health policy makers. In this paper we propose a method to estimate childhood acute lymphoblastic leukemia (ALL) life expectancy through the integration of traditional survival analysis and life expectancy tables. PATIENTS AND METHODS: The study included 305 incident cases registered by the Childhood Cancer Registry of Piedmont in 1979-1991. Vital status on 30 June 2004 was known for 304 cases. Survival analyses were carried out using the Kaplan-Meier method and the Gompertz model, according to the time period of diagnosis and gender. RESULTS: Cumulative survival at 5 years increased from 58.6% (95% CI 48.9-68.3) for cases diagnosed in March 1979-July 1982 to 79.1% (95% CI 70.8-87.5) in March 1987-February 1991 (P = 0.002). Average life expectancy increased from 46.1 years for boys and 42.6 years for girls diagnosed in March 1979-July 1982 to 58.3 and 69.1, respectively, in March 1987-February 1991. CONCLUSIONS: These analyses show an improvement over the time period of diagnosis of life expectancy for children with ALL.