Kenney L B, Miller B A, Ries L A, Nicholson H S, Byrne J, Reaman G H
Department of Pediatrics, University of Massachusetts Medical Center, Worcester 06155, USA.
Cancer. 1998 Apr 1;82(7):1396-400. doi: 10.1002/(sici)1097-0142(19980401)82:7<1396::aid-cncr25>3.0.co;2-0.
During the decade between 1980-1990, the rate of cancer in children in the U.S. increased. It is unknown whether cancer in infancy, which is biologically and clinically different from cancer in older children, also increased.
To evaluate changes in cancer incidence in infants in the U.S. age < 1 year, data from the Surveillance, Epidemiology, and End Results (SEER) program and the U.S. Bureau of the Census were used to construct age specific, population-based cancer incidence rates.
Overall, the annual cancer rate in infants increased from 189 cases per million infants between 1979-1981 to 220 between 1989-1991. At both timepoints, female infants had higher cancer rates than male infants. Although the rates for female infants remained stable at 223 between 1979-1981 versus 236 between 1989-1991, rates for male infants increased from 158 to 205 during the same timepoints. Male infants had increased rates of central nervous system (CNS) tumors (P < 0.05), neuroblastoma, and retinoblastoma; female infants had increased rates of teratomas (P < 0.01) and hepatoblastomas. Between 1979-1981, the three most common types of cancer in infants were neuroblastoma, leukemia, and renal tumors (27%, 15%, and 14%, respectively), and were neuroblastoma, CNS tumors, and leukemia between 1989-1991 (27%, 15%, and 13%, respectively).
This study shows that the rate of certain types of cancer in infants in the U.S. is increasing. Studies of both genetic and environmental factors are needed to explain these increased rates and the changing distribution of cancer in the first year of life.
在1980年至1990年的十年间，美国儿童癌症发病率有所上升。尚不清楚生物学和临床特征与大龄儿童癌症不同的婴儿癌症发病率是否也有所上升。
为评估美国1岁以下婴儿癌症发病率的变化，利用监测、流行病学和最终结果（SEER）计划以及美国人口普查局的数据构建了特定年龄、基于人群的癌症发病率。
总体而言，婴儿的年癌症发病率从1979 - 1981年的每百万婴儿189例增至1989 - 1991年的220例。在两个时间点，女婴的癌症发病率均高于男婴。尽管女婴的发病率在1979 - 1981年为223，在1989 - 1991年为236，保持稳定，但男婴的发病率在同一时间点从158增至205。男婴的中枢神经系统（CNS）肿瘤、神经母细胞瘤和视网膜母细胞瘤发病率上升（P < 0.05）；女婴的畸胎瘤和肝母细胞瘤发病率上升（P < 0.01）。1979 - 1981年，婴儿中最常见的三种癌症类型是神经母细胞瘤、白血病和肾肿瘤（分别占27%、15%和14%），1989 - 1991年则是神经母细胞瘤、CNS肿瘤和白血病（分别占27%、15%和13%）。
本研究表明美国婴儿某些类型癌症的发病率正在上升。需要对遗传和环境因素进行研究，以解释这些上升的发病率以及生命第一年癌症分布的变化。
