Bunin G R, Feuer E J, Witman P A, Meadows A T
Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania, USA.
Paediatr Perinat Epidemiol. 1996 Jul;10(3):319-38. doi: 10.1111/j.1365-3016.1996.tb00054.x.
As little is known about the aetiology of cancer in children, analysis of time trends may be useful. Recent data on time trends for paediatric cancers are very limited. We report here on trends in the incidence of 15 categories of cancer in children under 15 years of age from 1970 to 1989, using data from the Greater Delaware Valley Pediatric Tumor Registry in the US. Total cancer incidence increased 1% per year (P < 0.001). Neither acute lymphocytic leukaemia, acute myelocytic leukaemia, nor total leukaemia incidence changed significantly. In contrast, the incidence of central nervous system (CNS) tumours rose 2.7% per year (P < 0.001). All three subgroups of this category, glioma, primitive neuroectodermal tumor (PNET)/medulloblastoma, and other CNS tumours, showed increases. For glioma and PNET/medulloblastoma, trends differed by age, race, and/or gender. Among the other childhood cancers, significant increases were observed for non-Hodgkin lymphoma and neuroblastoma. For osteosarcoma and retinoblastoma, no overall change in incidence was observed, although decreases were observed in some age and race subgroups. The rise in CNS tumour incidence confirms previous reports from the US and Great Britain. The lack of change for acute lymphocytic leukaemia conflicts with other data from the US, but diagnostic changes appear to explain at least part of the discrepancy. The increase in neuroblastoma has also been observed in Great Britain. In contrast to our finding, investigators in the US and Great Britain have reported no rise in non-Hodgkin lymphoma. Analyses for more of the childhood cancers from other registries would aid in detecting and interpreting incidence trends in recent years.
由于对儿童癌症的病因了解甚少，分析时间趋势可能会有所帮助。目前关于儿童癌症时间趋势的最新数据非常有限。我们利用美国大特拉华谷儿科肿瘤登记处的数据，报告了1970年至1989年15岁以下儿童15类癌症的发病率趋势。癌症总发病率每年上升1%（P<0.001）。急性淋巴细胞白血病、急性髓细胞白血病以及白血病总发病率均无显著变化。相比之下，中枢神经系统（CNS）肿瘤的发病率每年上升2.7%（P<0.001）。该类别中的三个亚组，即胶质瘤、原始神经外胚层肿瘤（PNET）/髓母细胞瘤以及其他中枢神经系统肿瘤，均呈现上升趋势。对于胶质瘤和PNET/髓母细胞瘤，趋势因年龄、种族和/或性别而异。在其他儿童癌症中，非霍奇金淋巴瘤和神经母细胞瘤的发病率显著上升。骨肉瘤和视网膜母细胞瘤的发病率总体未观察到变化，尽管在某些年龄和种族亚组中出现了下降。中枢神经系统肿瘤发病率的上升证实了美国和英国先前的报告。急性淋巴细胞白血病发病率未发生变化这一情况与美国的其他数据相矛盾，但诊断变化似乎至少可以解释部分差异。在英国也观察到了神经母细胞瘤发病率的上升。与我们的发现相反，美国和英国的研究人员报告非霍奇金淋巴瘤发病率没有上升。对其他登记处更多儿童癌症进行分析，将有助于检测和解释近年来的发病率趋势。
