Gurney J G, Ross J A, Wall D A, Bleyer W A, Severson R K, Robison L L
Department of Community Health, School of Public Health, Saint Louis University, MO 63108-3342, USA.
J Pediatr Hematol Oncol. 1997 Sep-Oct;19(5):428-32. doi: 10.1097/00043426-199709000-00004.
Many cancers in infants demonstrate unique epidemiologic, clinical, and genetic characteristics compared with cancers in older children. Few epidemiologic reports, however, have focused on this important age group.
Population-based data from the Surveillance, Epidemiology, and End Results (SEER) program were used to estimate relative frequency, incidence rates, and average annual percentage change of rates among children in their first year of life (infants) who were diagnosed with a malignant neoplasm from 1973 to 1992 (N = 1461).
The greatest proportion of cases (12%) was diagnosed during the first month of life, with extracranial neuroblastoma accounting for 35% of this total. Overall, the average annual incidence rate was 223/1,000,000 infants. Extracranial neuroblastoma was the most common infant malignancy (58/1,000,000 infants per year), followed by leukemias (37/1,000,000), brain and central nervous system (CNS) tumors (34/1,000,000), and retinoblastoma (27/1,000,000). White infants had a 32% higher incidence rate than black infants. The average annual percentage increase in rates for all cancer from 1973 to 1992 was 2.9% (95% CI: 1.9%, 3.8%). For neoplasms with at least 100 cases, increasing trends were greatest for retinoblastoma (4.6%), CNS (4.1%), and extracranial neuroblastoma (3.4%).
Incidence rates increased notably over the study period. Future studies should consider the unique presentation of infants with cancer when developing new hypotheses related to cancer etiology and gene-environment interactions.
与大龄儿童的癌症相比，许多婴儿癌症表现出独特的流行病学、临床和遗传特征。然而，很少有流行病学报告关注这一重要年龄组。
利用监测、流行病学和最终结果（SEER）项目的基于人群的数据，来估计1973年至1992年期间被诊断为恶性肿瘤的一岁以内儿童（婴儿）的相对频率、发病率以及发病率的年均变化百分比（N = 1461）。
最大比例的病例（12%）在出生后第一个月被诊断出来，其中颅外神经母细胞瘤占总数的35%。总体而言，年均发病率为每100万婴儿中有223例。颅外神经母细胞瘤是最常见的婴儿恶性肿瘤（每年每100万婴儿中有58例），其次是白血病（每100万中有37例）、脑和中枢神经系统（CNS）肿瘤（每100万中有34例）以及视网膜母细胞瘤（每100万中有27例）。白人婴儿的发病率比黑人婴儿高32%。1973年至1992年期间所有癌症发病率的年均增长率为2.9%（95%CI：1.9%，3.8%）。对于至少有100例病例的肿瘤，视网膜母细胞瘤（4.6%）、中枢神经系统（4.1%）和颅外神经母细胞瘤（3.4%）的增长趋势最大。
在研究期间发病率显著增加。未来的研究在提出与癌症病因和基因 - 环境相互作用相关的新假设时，应考虑患癌婴儿的独特表现。
