Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan.
Department of Psychology, Eastern Michigan University, Ypsilanti, Michigan.
Pediatr Blood Cancer. 2019 Jan;66(1):e27428. doi: 10.1002/pbc.27428. Epub 2018 Aug 31.
Southeast Asia is undergoing a transition from infectious to chronic diseases, including a dramatic increase in adult cancers. Childhood cancer research in Thailand has focused predominantly on leukemias and lymphomas or only examined children for a short period of time. This comprehensive multisite study examined childhood cancer incidence and survival rates in Thailand across all International Classification of Childhood Cancer (ICCC) groups over a 20-year period.
Cancer cases diagnosed in children ages 0-19 years (n = 3574) from 1990 to 2011 were extracted from five provincial population-based Thai registries, covering approximately 10% of the population. Descriptive statistics of the quality of the registries were evaluated. Age-standardized incidence rates (ASRs) were calculated using the Segi world standard population, and relative survival was computed using the Kaplan-Meier method. Changes in incidence and survival were analyzed using Joinpoint Regression and reported as annual percent changes (APC).
The ASR of all childhood cancers during the study period was 98.5 per million person-years with 91.0 per million person-years in 1990-2000 and 106.2 per million person-years in 2001-2011. Incidence of all childhood cancers increased significantly (APC = 1.2%, P < 0.01). The top three cancer groups were leukemias, brain tumors, and lymphomas. The 5-year survival for all childhood cancers significantly improved from 39.4% in 1990-2000 to 47.2% in 2001-2011 (P < 0.01).
Both childhood cancer incidence and survival rates have increased, suggesting improvement in the health care system as more cases are identified and treated. Analyzing childhood cancer trends in low- and middle-income countries can improve understanding of cancer etiology and pediatric health care disparities.
东南亚正经历从传染病向慢性病的转变，包括成人癌症的急剧增加。泰国的儿童癌症研究主要集中在白血病和淋巴瘤上，或者只在短时间内检查儿童。这项全面的多中心研究调查了泰国所有国际儿童癌症分类（ICCC）组在 20 年内儿童癌症的发病率和生存率。
从五个省级基于人群的泰国登记处提取了 1990 年至 2011 年期间诊断为 0-19 岁儿童（n=3574）的癌症病例，这些登记处覆盖了约 10%的人口。评估了登记处质量的描述性统计数据。使用塞基世界标准人口计算了标准化发病率（ASR），并使用 Kaplan-Meier 方法计算了相对生存率。使用 Joinpoint 回归分析了发病率和生存率的变化，并报告为年百分比变化（APC）。
研究期间所有儿童癌症的 ASR 为每百万人口 98.5 例，1990-2000 年为每百万人口 91.0 例，2001-2011 年为每百万人口 106.2 例。所有儿童癌症的发病率均显著增加（APC=1.2%，P<0.01）。前三大癌症群体是白血病、脑肿瘤和淋巴瘤。所有儿童癌症的 5 年生存率从 1990-2000 年的 39.4%显著提高到 2001-2011 年的 47.2%（P<0.01）。
儿童癌症的发病率和生存率都有所提高，这表明随着更多病例被发现和治疗，医疗保健系统得到了改善。分析低收入和中等收入国家的儿童癌症趋势可以提高对癌症病因和儿科医疗保健差异的认识。
