Ross J A, Severson R K, Robison L L, Pollock B H, Neglia J P, Woods W G, Hammond G D
Children's Cancer Research Fund Epidemiology Research Unit, University of Minnesota, Minneapolis.
Cancer. 1993 May 15;71(10 Suppl):3415-21. doi: 10.1002/1097-0142(19930515)71:10+<3415::aid-cncr2820711747>3.0.co;2-#.
Cancer is the second leading cause of death in children younger than 15 years. Although 5-year survival rates have increased dramatically for many childhood tumors, more than 100,000 person-years of life are lost to childhood cancer each year. The exact proportion of pediatric patients with cancer who receive care at centers that use up-to-date therapeutic protocols (such as those affiliated with the Childrens Cancer Group (CCG) or the Pediatric Oncology Group (POG) is unknown.
Based on residence at the time of diagnosis, observed numbers of pediatric cancer cases seen by member institutions of the CCG and the POG in 1989 and 1990 were compared with the expected number of cases. Expected values were calculated from incidence rates obtained from the Surveillance, Epidemiology and End Results Program and population counts obtained from the US Census Bureau.
Results indicate that more than 90% of children younger than 15 years who have a diagnosis of malignant neoplasm are seen at an institution that is a member of either CCG or POG. The highest proportion seen occurs in the youngest (0-4 years) age group, and the proportion declines steadily with increasing age.
There are specific regions within the United States where the observed number of cases was substantially less than the expected number, including areas of Texas, Idaho, and Virginia. Although the exact reasons for these potential deficits are unknown, additional study of these areas is recommended.
癌症是15岁以下儿童的第二大死因。尽管许多儿童肿瘤的5年生存率已大幅提高，但每年仍有超过10万人年的生命因儿童癌症而丧失。在采用最新治疗方案的中心（如儿童癌症组（CCG）或儿科肿瘤学组（POG）所属机构）接受治疗的癌症儿科患者的确切比例尚不清楚。
根据诊断时的居住地，将CCG和POG成员机构在1989年和1990年观察到的儿科癌症病例数与预期病例数进行比较。预期值根据监测、流行病学和最终结果计划获得的发病率以及美国人口普查局获得的人口计数计算得出。
结果表明，超过90%被诊断为恶性肿瘤的15岁以下儿童在CCG或POG成员机构就诊。就诊比例最高的是最年幼（0 - 4岁）年龄组，且该比例随年龄增长而稳步下降。
在美国境内有一些特定地区，观察到的病例数大幅低于预期数，包括得克萨斯州、爱达荷州和弗吉尼亚州的部分地区。尽管这些潜在不足的确切原因尚不清楚，但建议对这些地区进行进一步研究。
