Siegel David A, King Jessica, Tai Eric, Buchanan Natasha, Ajani Umed A, Li Jun
Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia; and.
Cancer Surveillance Branch.
Pediatrics. 2014 Oct;134(4):e945-55. doi: 10.1542/peds.2013-3926. Epub 2014 Sep 8.
Cancer continues to be the leading disease-related cause of death among children and adolescents in the United States. More current information is needed to describe recent cancer trends and identify demographic and geographic variations.
We analyzed data from the National Program of Cancer Registries and Surveillance, Epidemiology, and End Results statewide registries representing 94.2% of the US population to identify cancers diagnosed among persons aged 0 to 19 years during 2001-2009. Age-adjusted rates and annual percentage change for trends were calculated. Data were stratified by age, gender, race, ethnicity, and geography.
We identified 120,137 childhood and adolescent cancer cases during 2001-2009 with an age-adjusted incidence rate of 171.01 per million. The overall rate of all cancers combined remained stable over time (annual percent change [APC], 0.3%; 95% confidence interval [CI], -0.1 to 0.7). There was an increase in the overall cancer trend among African American children and adolescents (APC, 1.3%; 95% CI, 0.2 to 2.5). An increasing trend for thyroid cancer was observed among both genders (APC, 4.9%; 95% CI, 3.2 to 6.6) and specifically among adolescents and those in the Northeast, South, and West regions of the United States. Renal carcinoma incidence was increasing significantly overall (APC, 5.4%; 95% CI, 2.8 to 8.1). Extracranial and extragonadal germ cell tumors and melanoma were both significantly decreasing.
This study reports the novel finding that renal carcinoma rates are increasing among children and adolescents. This study confirms that thyroid cancer rates are increasing and further describes rising cancer rates among African Americans.
癌症仍然是美国儿童和青少年中与疾病相关的首要死因。需要更多最新信息来描述近期癌症趋势,并确定人口统计学和地理差异。
我们分析了来自国家癌症登记计划以及监测、流行病学和最终结果全州登记处的数据,这些数据代表了94.2%的美国人口,以确定2001 - 2009年期间0至19岁人群中诊断出的癌症。计算了年龄调整率和趋势的年度百分比变化。数据按年龄、性别、种族、族裔和地理位置进行分层。
我们在2001 - 2009年期间确定了120,137例儿童和青少年癌症病例,年龄调整发病率为每百万171.01例。所有癌症合并的总体发病率随时间保持稳定(年度百分比变化[APC],0.3%;95%置信区间[CI],-0.1至0.7)。非裔美国儿童和青少年的总体癌症趋势有所增加(APC,1.3%;95% CI,0.2至2.5)。在男性和女性中均观察到甲状腺癌呈上升趋势(APC,4.9%;95% CI,3.2至6.6),特别是在美国东北部、南部和西部地区的青少年中。肾癌发病率总体上显著增加(APC,5.4%;95% CI,2.8至8.1)。颅外和性腺外生殖细胞肿瘤以及黑色素瘤均显著下降。
本研究报告了一个新发现,即儿童和青少年中的肾癌发病率正在上升。本研究证实甲状腺癌发病率正在上升,并进一步描述了非裔美国人中不断上升的癌症发病率。