Sultan Iyad, Alfaar Ahmad S, Sultan Yaseen, Salman Zeena, Qaddoumi Ibrahim
Department of Pediatrics and Artificial Intelligence and Data Innovation Office (AIDI), King Hussein Cancer Center, Amman, Jordan.
Department of Ophthalmology, Charité Universitätsmedizin Berlin, Berlin, Germany.
PLoS One. 2025 Jan 3;20(1):e0314592. doi: 10.1371/journal.pone.0314592. eCollection 2025.
The SEER Registry contains U.S. cancer statistics. To assess trends in incidence and survival and the impact of demographic factors among pediatric patients with cancer, we assessed nearly 5 decades (1975-2019) of data.
All patients below the age of 20 with histology-confirmed malignancy were studied. Kaplan-Meier survival curves were generated to evaluate survival trends across treatment periods and ICCC classes. JoinPoint analysis was conducted to identify changes in incidence and survival.
The incidence of childhood cancer increased from 14.23 cases per 100,000 children in 1975-1979 to 18.89 in 2010-2019, with an average annual percent change of 0.73. This rise was more pronounced in several cancers, including leukemias, lymphomas, brain tumors, hepatic tumors, and gonadal germ cell tumors. Age-adjusted cancer mortality decreased from 4.9 to 2.3 per 100,000. Cancer-related mortality was consistently higher in boys than in girls, and in Black children than in White children. Survival significantly improved, with 5- and 10-year survival rates rising from 63.1% to 85.2% and from 58.8% to 82.7%, respectively. Leukemias showed a substantial increase in 5-year survival from 48.2% ± 1.7% to 85.1% ± 0.4% in 2010-2019. Lymphomas also showed significant improvement, with survival increasing from 72.9% ± 1.7% to 94.2% ± 0.3%. Despite these improvements, the survival of CNS tumors, bone tumors, and sarcomas remained suboptimal, with 5-year survival estimates of approximately 60%. Our joinpoint analysis confirmed our findings but revealed an interesting increase in the incidence of lymphomas limited to the years between 2005 and 2014.
This research elucidates advancements in survival among pediatric patients with cancer. The results offer critical perspectives on pediatric oncology, highlighting the imperative for ongoing innovation in therapeutics. Although the increase in incidence may partially stem from enhanced diagnostic capabilities and more comprehensive registration processes, the underlying causes remain unclear.
监测、流行病学与最终结果（SEER）登记处包含美国癌症统计数据。为评估儿童癌症患者的发病率和生存率趋势以及人口统计学因素的影响，我们评估了近50年（1975 - 2019年）的数据。
研究所有年龄在20岁以下且组织学确诊为恶性肿瘤的患者。生成Kaplan - Meier生存曲线以评估各治疗时期和国际儿童肿瘤学会（ICCC）分类的生存趋势。进行JoinPoint分析以确定发病率和生存率的变化。
儿童癌症的发病率从1975 - 1979年的每10万名儿童14.23例增加到2010 - 2019年的18.89例，年均变化率为0.73%。这种上升在几种癌症中更为明显，包括白血病、淋巴瘤、脑肿瘤、肝肿瘤和性腺生殖细胞肿瘤。年龄调整后的癌症死亡率从每10万人4.9例降至2.3例。癌症相关死亡率男孩始终高于女孩，黑人儿童高于白人儿童。生存率显著提高，5年和10年生存率分别从63.1%升至85.2%，从58.8%升至82.7%。白血病的5年生存率在2010 - 2019年从48.2%±1.7%大幅增至85.1%±0.4%。淋巴瘤也有显著改善，生存率从72.9%±1.7%增至94.2%±0.3%。尽管有这些改善，中枢神经系统肿瘤、骨肿瘤和肉瘤的生存率仍不理想，5年生存率估计约为60%。我们的JoinPoint分析证实了我们的发现，但揭示了一个有趣的现象，即淋巴瘤发病率在2005年至2014年期间有所增加。
本研究阐明了儿童癌症患者生存率的进步。研究结果为儿童肿瘤学提供了关键视角，突出了治疗方法持续创新的必要性。虽然发病率的增加可能部分源于诊断能力的提高和登记过程的更全面，但根本原因仍不清楚。
