Incidence of Childhood Lymphoma in Northern Israel, 1973-1990

We retrospectively analyzed all 164 cases of pediatric lymphoma diagnosed in northern Israel during the 18-year period from 1973 to 1990. Our findings generally conformed to those of other studies with regard to annual incidence (24.7/million), age at diagnosis (5 to 9 years for Jewish males, later for others), histology (Hodgkin's disease most commonly), and male predominance. The northern Israeli pediatric lymphoma pattern of incidence is similar to the Asian-African-South American pattern and unlike that of Europe or North America; in Israel, lymphoma rather than brain tumor is the second most common childhood malignancy. The nodular sclerosing variant was the most common histology seen in Hodgkin's lymphoma (especially in females), followed by mixed cellularity. Malignancies are generally more common in Jewish children but lymphomas in particular were seen more often in Arabs (28.7/million), while the Ashkenasi (20.81 million) and Sephardi (21.61 million) Jewish populations had similar incidences. The high rate of consanguineous marriages among Arabs and their lower socioeconomic level may explain the high incidence of lymphomas in this group.     

Staphylococcal Pyomyositis in a Child with Fanconi Aplastic Anemia

We retrospectively analyzed all 164 cases of pediatric lymphoma diagnosed in northern Israel during the 18-year period from 1973 to 1990. Our findings generally conformed to those of other studies with regard to annual incidence (24.7/million), age at diagnosis (5 to 9 years for Jewish males, later for others), histology (Hodgkin's disease most commonly), and male predominance. The northern Israeli pediatric lymphoma pattern of incidence is similar to the Asian-African-South American pattern and unlike that of Europe or North America; in Israel, lymphoma rather than brain tumor is the second most common childhood malignancy. The nodular sclerosing variant was the most common histology seen in Hodgkin's lymphoma (especially in females), followed by mixed cellularity. Malignancies are generally more common in Jewish children but lymphomas in particular were seen more often in Arabs (28.7/million), while the Ashkenasi (20.81 million) and Sephardi (21.61 million) Jewish populations had similar incidences. The high rate of consanguineous marriages among Arabs and their lower socioeconomic level may explain the high incidence of lymphomas in this group.     

Lorraine childhood cancer registry: incidence, survival 1983-1999]

BACKGROUND: Cancer in childhood account for less than 1% of all cancers and for the second most important cause of death for children aged less than 15 years in France, injuries being the leading cause. Compared to adult cancers, childhood cancers' particularities justify to create pediatric registries. The first French population-based registry was created in Lorraine in 1983. The incidence and survival results from a 17 year-period are presented. METHODS: In Lorraine region, all children (0-14 years) with cancer diagnosed between 1983 and 1999 were included. Crude, age-standardized (world population) and cumulative incidence rates were calculated just as overall, specific-disease and event-free survival rates, using Kaplan-Meier methods. RESULTS: With 1086 registered cases, the crude incidence rate per million children is 132.4, the age-standardized incidence rate per million is 137.5; 1 out of every 500 children will develop cancer before the age of 15 years. The incidence of all cancers combined is slightly higher in males than in females with a M/F ratio of 1.13. For this 17 years-period, no trend in childhood cancer incidence is observed. The main cancer groups are leukemia (30.7%), brain and spinal tumors (23.2%) and lymphomas (12.9%), sympathetic nervous system tumors (7.4%), soft-tissue sarcomas (6.1%), renal tumors (5.2%), and bone tumors (5.0%). Five-year specific survival rates for all cancers combined is 71.4% [95% CI: 68.5-74.3]. The prognosis is significatively worse for the<1 year age group (55%) and for some histologic types: brain stem gliomas (27%), hepatic tumors (43%), osteosarcomas (57%), neuroblastomas (65%), rhabdomyosarcomas (55%). DISCUSSION: Relative distribution of histologic groups, incidence and survival rates observed in Lorraine registry are compatible with the general pattern in the European Union cancer registries. The lack of significative trend in incidence unlike others country may be explained by too small numbers. CONCLUSION: The acquired experience in developping this regional registry allowed us to create a national registry of childhood solid tumors and contribute to valid national data.     

Cancer incidence among children in France, 1990-1999

BACKGROUND: Cancer is the second most important cause of death for children aged less than 15 years in France, unintentional injuries being the leading cause. The aim of the present study was to estimate the incidence of childhood cancer from six Childhood Cancer Registries covering 32% of France. PROCEDURE: Incident cancer cases diagnosed between 1990 and 1999 in children (0-14 years) resident in the administrative areas covered by each Registry were included. Annual age-standardized rates (ASRs) were adjusted by the world population. The estimated annual percent change (EAPC) was used to measure trend towards changes in the annual age-standardized incidence rate. RESULTS: With 4234 registered cases, the ASRs per million children were 137.5 for all cancers combined, 42.3 for leukemia, 29.1 for central-nervous-system tumors, 15.6 for lymphomas, 14.1 for sympathetic-nervous-system tumors, and 9.1 for renal tumors. The ASR of all cancers combined was slightly higher in males (145.8 per million children) than in females (128.7 per million children) with an M/F ratio of 1.2. No significant incidence trend was observed, with an EAPC of +0.2% [IC 95% (-2.5; +3.0); P = 0.89]. CONCLUSIONS: The estimated incidence rates are similar to those reported in previous studies in European and North American countries. These results will contribute to the development of National Registration of Childhood Cancer in France and support the national research program on childhood cancer.     

Cancer Incidence and Survival Among Infants in Israel, 1998–2007

Cancer during the first year of life is relatively rare and often has clinical and biological properties different from those of the same histologic type of cancer occurring in older children. The aim of this study was to find differences in epidemiology and survival between infants and older children and to compare the percentage of distribution of infant cancer types in Israel with that reported in the United States. We collected infant <1 year of age cases diagnosed between 1998 and 2007 as having cancer from the database of the Israel National Cancer Registry, a total of 309 cases with an incidence rate of 228.5 cases per million. The largest group was diagnosed with neuroblastoma (35%) with an incident rate of 80 per million, followed by leukemia (15.9%), with acute lymphoid leukemia and acute myeloid leukemia accounting for most of this group and central nervous system malignancies comprised 10.7% of infant cancer. One hundred and fifty four new cases of infant girls was diagnosed compared to 155 infant boys with an incidence rates of 234 cases per million for girls and 224.7 for boys, not statistically significant (F:M rate ratio of 1.04). The 5-year survival rates seen in the different groups were leukemia: 55.3%, lymphoma: 71%, CNS tumors: 53.3%, neuroblastoma: 93.4%, retinoblastoma: 94.7% renal tumors: 90.9%, hepatic tumors: 63.3%, soft tissue sarcoma: 76.2%, germ cell neoplasms: 83.3%, and other epithelial neoplasms: 100%. Our study did not find survival differences with statistical significance upon comparing survival rates between different genders and ethnic groups.     

Current outlook of childhood cancer epidemiology in a middle-income country under a public health insurance program

In Mexico, childhood cancer (0–18 years) is treated in a multidisciplinary way while providing care for more than half of the affected children through a public medical insurance. This insurance is given to all children who do not have any health care coverage in Mexico. This program is offered to the poorest of all Mexicans. All the children with this disease are submitted to pathology diagnosis and treatment according to national treatment protocols from 57 accredited medical institutions. From 2007 to 2015, a total of 24,039 children with cancer have been registered; the male gender predominates by 55%. The highest incidence was in the group aged between 0 and 4 years. Every year, there has been an increment in registration. In 2015, there were 3,433 new patients with an incidence of 150.1/million. In the same year, the incidence for all types of leukemia increased to 89.5/million. But for acute lymphoblastic leukemia, the incidence was found to be 79.8/million, which is extremely high. The mortality rate for all these patients in 2015 was 5.3/100,000. However, with regard to children aged between 15 and 18 years, the mortality rate was 8.5/100,000. Abandonment rate was 10%, and there were nine state institutions that had a mortality rate between 25% and 50% among their patients. Coincidentally, as per the Human Development Index, the parameters for education, health, and income were low for those nine institutions. The purpose of this work is to show the epidemiology and the burden we are facing due to this disease.     

2010年与2015年江西省儿童恶性肿瘤疾病负担研究

目的 评估2010与2015年江西省儿童恶性肿瘤的疾病负担情况及其变化趋势,为儿童恶性肿瘤防控提供依据。方法 从中国分省份疾病负担研究数据中选取2010年和2015年江西省儿童恶性肿瘤的发病数、死亡数、过早死亡损失寿命年（YLL）、伤残损失寿命年（YLD）和伤残调整寿命年（DALY）等数据,使用2010年全国人口普查数据作为标准人口,计算标化的发病率、死亡率和DALY率,评价该省的恶性肿瘤发病、死亡和疾病负担的变化情况。结果 2010年、2015年江西省儿童恶性肿瘤的发病数、死亡数和DALY均呈现为男童 > 女童,5~14岁组 > 0~4岁组,但发病率、死亡率和DALY率均呈现为男童 > 女童,0~4岁组 > 5~14岁组。2015年儿童恶性肿瘤的标化发病率在0~4岁组下降6.66%,5~14岁组下降17.56%;标化死亡率在0~4岁组下降11.34%,5~14岁组下降21.78%;标化DALY率在0~4岁组下降11.27%,5~14岁组下降21.67%。2015年和2010年的儿童恶性肿瘤标化DALY率排在前三位的为白血病、脑癌和非霍奇金淋巴瘤。结论 江西省需要重点防治的儿童恶性肿瘤是白血病、脑癌和非霍奇金淋巴瘤,5岁以下儿童和男童是重点防控对象,2015年疾病负担相对2010年有所下降。     

Neuroblastoma: changing incidence and survival in young people aged 0-24 years. A report from the North of England Young Persons' Malignant Disease Registry

BACKGROUND AND PROCEDURE: Population based data for neuroblastoma in children and young adults under 25 years at diagnosis were ascertained from the Northern Region Young Persons' Malignant Disease Registry for the period 1968-1995. Age-standardised incidence rates were calculated (ASR) and changes in incidence and survival were investigated. Over the study period 144 patients were registered, of these 136 were children under 15 years at diagnosis (median age: 2.2 years, ASR: 8.6 cases per million children per year), and 8 were 15-24 years (ASR 0.6). RESULTS AND CONCLUSIONS: Incidence of childhood neuroblastoma in the North of England increased significantly over time; ASRs were 5.8 for 1968-1981 and 9.5 for 1982-1995 (rate ratio: 1.6, 95%; CI 1.2-2.3). The increase in incidence was seen in both infants and older children, and in both low stage and advanced disease. Overall 5 year survival was 15% for 1968-1981 and 40% for 1982-1995 (P < 0.0001). Significant improvements in survival were documented across different stage and age-groups, including those over 1 with stage 4 disease (0% versus 18%, P < 0.0001). Further research is needed to investigate the reasons for the increasing incidence of neuroblastoma.     

Childhood cancer in Ireland: a population-based study.

BACKGROUND: Population-based studies of childhood cancer incidence, survival and mortality make an important contribution to monitoring the successful implementation of new treatment guidelines and to understanding the epidemiology of these diseases. METHODS: We analysed incidence and survival data for cancers diagnosed in children under 15 years of age in the Republic of Ireland during 1994-2000 (the first 7 years of National Cancer Registry coverage), and longer term mortality trends. RESULTS: World age-standardised incidence rates in Ireland averaged 142 cases per million children per year, slightly higher than the European average and slightly lower than the US average, although differences varied by diagnostic group. Observed 5-year survival in Ireland (79% overall) was slightly higher than European and US averages, and was significantly higher for acute non-lymphocytic leukaemia (67%) and (compared with the USA) significantly lower for Hodgkin lymphoma (83%). No significant increases in incidence rates were evident from the available 7 years' data, either overall or for particular diagnostic groups. Rates of childhood cancer mortality have declined markedly since the 1950s. CONCLUSIONS: Data presented here are in line with other developed countries and suggest major improvements in treatment and consequent survival.     

Epidemiology of childhood tuberculosis in Switzerland between 1996 and 2011

Approximately 9 million cases of tuberculosis (TB) are reported annually and half a million occur in children <15 years of age. Globally, TB notifications in children have been neglected for decades although childhood TB may represent a sentinel for ongoing transmission. Data included in this study were collected from the TB database of the Swiss Federal Office of Public Health, which includes culture-confirmed TB and/or cases treated with ≥3 anti-mycobacterial drugs. Data from all children <15 years of age reported between 1996 and 2011 were analyzed. A total of 320 cases of TB (166 cultures confirmed, 5 confirmed by nucleic acid amplification, 149 other than definite cases) were reported with an overall incidence rate of 1.6 per 100,000 children (range 1.2–2.2). A total of 154 (48 %) children were younger than 5 years of age and 141 (44 %) were born in Switzerland. Children below 5 years of age were more likely to be Swiss-born compared to children aged 10 to 14 years (74 % versus 26 %). When analyzing the country of origin, only 55 children (17 %) were of Swiss origin. Of all children with foreign origin, 117 (47 %) were from a country within the WHO European Region. In 288 (90 %) of all notified cases, the site of disease was the lung. Mycobacterial culture was positive in 166 cases (51.9 %) with 1.8 % multi-drug-resistance. The overall incidence of childhood TB disease reported in Switzerland remained stable over a 16-year period with a remarkable high rate of very young patients of foreign origin. Only half of the reported cases were culture confirmed, highlighting the need for better diagnostic tests in childhood TB.     

Incidence and survival analyses in children with solid tumours diagnosed in Sweden between 1983 and 2007

Aim: Solid tumours constitute 40% of childhood malignancies. The Swedish Childhood Cancer Registry is population based and includes all children with cancer reported from the six paediatric oncology centres in Sweden. The aim was to investigate incidence and survival. Methods: We used the new WHO ICCC‐3 for reclassification of the patients. Incidence and survival analyses were performed in the study population. Results: Two thousand four hundred and eighty‐seven children (<15 years) were diagnosed with solid tumours in Sweden between 1983 and 2007. The distribution of diagnoses was similar to that reported in other studies. The annual incidence was 65.3 per million children. The survival rates at 10 years of follow‐up have improved significantly when comparing the two time periods, 1983–1995 and 1995–2007 (76 vs. 82%; p < 0.01). Conclusions: The mean annual incidence of solid tumours in children was 65.3/million and has been stable during the study period. Survival rates for solid tumours at 5, 10 and 20 years follow‐up were 80, 79 and 76%, respectively.     

Incidence of childhood solid tumours in Lublin region from 1988 to 2000

The purpose of this study was the analysis of number and structure of new solid tumours and tumour morbidity among children 0-17 years old, in the Lublin Region of Poland, from 1988 to 2000. The analysis was based on sex, age and place of domicile (urban/rural region). During this time in the Lublin Region 344 cases of childhood solid tumours were reported; it was 36.4% of all childhood cancers diagnosed in this region. The structure of the disease was related to sex, age and the place of living. The mean morbidity rate was 42.2 per 1 mln (among boys - 42.2, girls - 42.4). The highest incidence rate was observed among children 0-4 years old (78.1 per 1 million). Higher morbidity was noted among patients living in urban regions (47.3 vs 37.6 / million).     

Cutaneous melanoma in childhood and adolescence

Using population-based data from the Surveillance Epidemiology and End Results Program of the National Cancer Institute, melanoma occurring during childhood was evaluated. Compared to adult cases of melanoma, childhood cases had a higher proportion of females (61%) and non-Caucasians (6.5%). The incidence of melanoma increased 85% among 15- to 19-year-olds from 1973 to 1996. Incidence for 15- to 19-year-olds was higher in southern (23.9/million) than northern registries (14.5/million). Non-Caucasians had 3-30% of the cases expected compared to Caucasians. Overall survival of children/adolescents with melanoma was 89% and 79% at 5 and 20 years post diagnosis, respectively. The majority of deaths were directly attributed to melanoma (72%).     

Outcome of pediatric patients with end-stage renal disease in Switzerland 1973-1982

The annual incidence of end-stage renal disease (ESRD: 1.32 patients aged 1/2-16 years per million population or 6.5 per million children of same age) and the causes have remained remarkably constant over the last 15 years in Switzerland. 58 patients (69%) were treated by dialysis and/or renal transplantation. The overall survival rate was 77% at 5 years and 65% at 10 years. 26 untreated patients (31%) died of uremia. They had not been treated despite existing facilities for the following reasons: Young age (7 of the 8 patients being less than 2 years old), psychosocial reasons (6), severe mental retardation (6) and associated problems (6). It is estimated that even in the future 20% of all pediatric patients with ESRD will be considered unsuitable for therapy by dialysis and renal transplantation.     

Population-based epidemiology of invasive pneumococcal infection in children in nine urban centers in Canada, 1994 through 1998

PURPOSE: To describe the epidemiology of invasive pneumococcal infections in Canadian children 0 to 12 years old. METHODS: At each of nine urban centers, active surveillance was conducted to identify all cases of invasive pneumococcal infection in children during 1994 to 1998. Postal codes were used to distinguish cases resident in defined urban areas from referral cases. Census data were obtained for each defined area to calculate age-specific incidence rates. Features of population-based cases were described. RESULTS: From an average defined population of approximately 1 million children, 937 eligible cases arose. Those 6 to 17 months old had the highest average incidence rate of 98.6/100 000/year. The average cumulative risk of infection was 1 in 460 between birth and 59 months, by which age 92% of cases had occurred. Among cases younger than 2 years of age, simple bacteremia accounted for 66%, pneumonia with bacteremia accounted for 14.7% and meningitis accounted for 11% (average incidence rate, 9.0/100 000/year). An underlying illness was present in 16% of all cases. The mortality rate was 1.8%. CONCLUSIONS: Invasive pneumococcal infections are relatively common in early childhood, based on 5 years of data from nearly 20% of the Canadian population ages 0 to 12 years. These data will be valuable for calculating the economic case for universal infant vaccination with newly available vaccines.     

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??In 2014??a total of 359 000 cases of tuberculosis??0-14 years old?? in children were reported worldwide??accounting for 6.5 percent of the registered TB cases. According to China’s research data in 2013??the PPD positive??≥10 mm??rate of children aged 5 to 15 in different TB epidemic areas was 8.09% to 21.26%. In 2015??6 861 cases of tuberculosis in children were reported nationwide??with a incidence of 3.03/100 000. In 2014??the national TB mortality rate among children aged 0 to 14 was 0.12/100 000. The diagnosis of childhood tuberculosis should be based on a comprehensive assessment of evidence such as contact history??clinical examination and related examinations. The principles of childhood TB treatment are the same as those of adults. At present the state council issued a national tuberculosis control program??put forward to improve the prevention and treatment of tuberculosis in children??to provide technical training to pediatricians on TB control??and to standardize the diagnosis and treatment of childhood tuberculosis.     

Incidence and survival of childhood Langerhans cell histiocytosis in Northwest England from 1954 to 1998

BACKGROUND: Langerhans cell histiocytosis (LCH) is a rare proliferative disorder of pathological Langerhans cells, for which the aetiology and pathogenesis remain largely unknown. PROCEDURE: Information on the 101 children with LCH registered with the population-based Manchester Children's Tumour Registry (MCTR) between 1954 and 1998 was extracted from the records of the MCTR. This included age, sex, date of diagnosis, systems affected at diagnosis and follow-up. RESULTS: The overall incidence rate for LCH was 2.6 cases per million child years. In those under 1 year of age the incidence rate was 9.0 cases per million child years, compared to 0.7 cases per million in those aged 10-14 years (P < 0.0001 for age trend). There was no evidence of seasonal variation in presentation by month of birth or first symptom. Bone was the most common site of disease involvement (67% of cases), followed by skin (37%) and soft tissue (22%). The overall survival rate has improved over time, from 57% in 1954-1968 to 74% in 1985-1998. Ninety percent of deaths were due to disease progression, the remainder were due to complications of intensive therapy. The site of LCH lesions and extent of disease present at diagnosis strongly predicted survival outcome. Patients with initial liver involvement had a 5-year survival rate of 25% compared with 93% for those with bone lesions alone at diagnosis. CONCLUSIONS: Incidence rates varied significantly by age at diagnosis, and have been stable over time. Survival has improved considerably over time, but varies strongly by age and systems affected at diagnosis.     

儿童结核病流行病学及诊治现状

2014年, 全球共报告35.9万例儿童（0～14岁）结核病,占登记报告结核病病例的6.5%。2013年我国研究数据显示,不同结核病疫情地区5～15岁儿童的结核菌素试验（PPD）阳性率为8.09%～21.26%（≥10 mm）。2015年,全国共报告儿童肺结核患者6861例,发病率为3.03/10万。2014年,全国0～14岁儿童结核病死亡率为0.12/10万。儿童结核病诊断要基于对接触史、临床检查和相关检查等证据的全面评估。儿童结核病治疗原则与成人相同。目前国务院下发了《“十三五”全国结核病防治规划》,提出要完善儿童结核病的防治措施,对儿科医生开展结核病防治技术培训,规范儿童结核病的诊断和治疗服务。     

Intussusception in children in Southern Israel: disparity between 2 populations

BACKGROUND: Intussusception has been associated with 1 rotavirus vaccine. Our objective was to determine intussusception rates in children in southern Israel during a 15-year period before the introduction of new rotavirus vaccines. METHODS: All children born at the Soroka Medical Center are hospitalized in that center, enabling population-based studies. Two populations reside in Southern Israel: the Jewish population (comparable to a Western population) and the Bedouin population (comparable to a developing population). Retrospectively, all children <5 years of age admitted with ICD-9 code for intussusception were recorded as well as their demographic and clinical data. RESULTS: During 1990-2004, 316 patients with intussusception [241 (76%) Jewish children and 75 (24%) Bedouin children] were recorded. None died. The mean annual rates for children <5 years (per 100,000) were 49.3 +/- 17.4 and 18.9 +/- 9.6 for Jewish and Bedouin children, respectively (P < 0.001), with a significant increase in intussusception rates during the study period in Bedouin (P = 0.022), but not in Jewish children (P = 0.38). Mean annual intussusception rates per 100,000 for children <12 months were 199.6 +/- 5.2 and 66.8 +/- 44.1 for Jews and Bedouin infants, respectively (P < 0.001). In Bedouin children, a significantly higher number of cases were observed from March to May, whereas no seasonality pattern was noted in Jewish children. Negative correlation between intussusception and gastroenteritis was found in Bedouin infants during the summer months, whereas no such correlation was found in Jewish infants. CONCLUSIONS: Pre-rotavirus vaccination intussusception rate is high especially among Jewish infants in Southern Israel. Intussusception rates increased significantly during the study period in Bedouin infants.