lymphoma survival rate by age | The Lorraine Register of Childhood cancers: incidence,

The Lorraine Register of Childhood cancers: incidence, 



Summary
Context and objectives. – Childhood cancers account for less than 1% of all cancers and the second cause of death among children aged 1 to 14 after accidents. Their specificities justify the existence of pediatric registries. The first French population register was created in Lorraine in 1983; Its results over a period of 17 years of registration are presented in terms of incidence and survival.

Materials and methods. – All cases of cancer diagnosed from 1983 to 1999 in Lorraine children aged 0 to 14 years were included. The gross, standardized (global population) and cumulative incidence rates, and the overall, specific and event-free survival rates (according to the Kaplan-Meier method) were calculated.

Results. – With a total of 1086 registered cases, the gross incidence is 132.4 per million per annum, the standardized incidence of 137.5 per million per annum; A child on 500 is likely to develop cancer before the age of 15. The overall incidence is higher for boys than for girls (sex ratio: 1.13). Over this 17-year period, the incidence remained stable. The type distribution is as follows: Leukemias (30.7% of cases), central nervous system tumours (23.2%), lymphomas (12.9%), sympathetic nervous system tumours (7.4%), soft tissue sarcomas (6.1%), renal tumours (5.2%) and bone (5.0%). The specific survival rate for all cancers is 71.4% [CI 95%: 68.5 – 74,3]. It is significantly lower before the age of one year (55%) and in certain types of cancers: brain stem gliomas (27%), liver tumours (43%), Osteosarcomas (57%), neuroblastoma (65%), Rhabdomyosarcomas (55%).

Discussion. – The incidence, histological distribution and survival observed from the data in the Lorrain register are comparable to the data of the European Union registers. The lack of a significant trend in incidence, unlike other countries, can be explained by the weakness of the workforce.

Conclusion. – The experience gained in activating this first regional register has enabled the establishment of a national registry of solid tumors and contributes to the validation of its data.

Abstract
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 tumours (7.4%), soft-tissue sarcomas (6.1%), renal tumors (5.2%), and bone tumours (5.0%). Five-year specific survival rates for all cancers combined is 71.4% [95% CI: 68.5 – 74.3]. The prognosis is significantly 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 significant trend in incidence unlike others country may be explained by too small numbers.

Conclusion. – The acquired experience in developing this regional registry allowed us to create a national registry of childhood solid tumors and contribute to valid national data.