Swaminathan Rajaraman, Rama Ranganathan, Shanta Viswanathan
Division of Epidemiology and Cancer Registry, Cancer Institute (WIA), Chennai, Tamil Nadu, India.
Int J Cancer. 2008 Jun 1;122(11):2607-11. doi: 10.1002/ijc.23428.
Childhood cancers (age at diagnosis: 0-14 years) comprise a variety of malignancies, with incidence varying worldwide by age, sex, ethnicity and geography, that provide insights into cancer etiology. A total of 1,334 childhood cancers registered in population-based cancer registry, Chennai, India, during 1990-2001 and categorized by International Classification of Childhood Cancer norms formed the study material. Cases included for survival analysis were 1,274 (95.5%). Absolute survival was calculated by actuarial method. Cox proportional hazard model was used to elicit the prognostic factors for survival. The age-standardized rates for all childhood cancers together were 127 per million boys and 88 per million girls. A decreasing trend in incidence rates with increasing 5-year age groups was observed in both sexes. The top 5 childhood cancers were the same among boys and girls: leukemias, lymphomas, central nervous system neoplasms, retinoblastomas and renal tumors. The highest 5-year absolute survival was observed in Hodgkin's disease (65%) followed by Wilm's tumor (64%), retinoblastomas (48%), non-Hodgkin's lymphomas (47%), osteosarcomas (44%), acute lymphoid leukemia and astrocytoma (39%). Multifactorial analysis of age at diagnosis and sex showed no differences in the risk of dying for all childhood cancers. Completeness of treatment and type of hospital combination emerged as a prognostic factor for survival for all childhood cancers together (p < 0.001), acute lymphoid leukemia (p < 0.001) and non-Hodgkin's lymphoma (p = 0.04). A Childhood Cancer Registry with high-resolution data collection is advocated for in-depth analysis of variation in incidence and survival.
儿童癌症（诊断年龄：0至14岁）包括多种恶性肿瘤，其发病率在全球范围内因年龄、性别、种族和地理位置而异，这为癌症病因研究提供了线索。1990年至2001年期间，印度钦奈基于人群的癌症登记处登记的1334例儿童癌症病例，并按照国际儿童癌症分类标准进行分类，构成了研究材料。纳入生存分析的病例为1274例（95.5%）。采用精算方法计算绝对生存率。使用Cox比例风险模型来确定生存的预后因素。所有儿童癌症的年龄标准化发病率分别为每百万男孩127例和每百万女孩88例。在两个性别中均观察到发病率随5岁年龄组增加而呈下降趋势。男孩和女孩中排名前5的儿童癌症相同：白血病、淋巴瘤、中枢神经系统肿瘤、视网膜母细胞瘤和肾肿瘤。霍奇金病的5年绝对生存率最高（65%），其次是威尔姆斯瘤（64%）、视网膜母细胞瘤（48%）、非霍奇金淋巴瘤（47%）、骨肉瘤（44%）、急性淋巴细胞白血病和星形细胞瘤（39%）。对诊断年龄和性别的多因素分析表明，所有儿童癌症的死亡风险没有差异。治疗的完整性和医院类型组合共同成为所有儿童癌症（p < 0.001）、急性淋巴细胞白血病（p < 0.001）和非霍奇金淋巴瘤（p = 0.04）生存的预后因素。提倡建立一个具有高分辨率数据收集功能的儿童癌症登记处，以深入分析发病率和生存率的差异。
