SummaryBackgroundCancer is a major cause of death in children worldwide, and the recorded incidence tends to increase with time. Internationally comparable data on childhood cancer incidence in the past two decades are scarce. This study aimed to provide internationally comparable local data on the incidence of childhood cancer to promote research of causes and implementation of childhood cancer control.MethodsThis population-based registry study, devised by the International Agency for Research on Cancer in collaboration with the International Association of Cancer Registries, collected data on all malignancies and non-malignant neoplasms of the CNS diagnosed before age 20 years in populations covered by high-quality cancer registries with complete data for 2001–10. Incidence rates per million person-years for the 0–14 years and 0–19 years age groups were age-adjusted using the world standard population to provide age-standardised incidence rates (WSRs), using the age-specific incidence rates (ASR) for individual age groups (0–4 years, 5–9 years, 10–14 years, and 15–19 years). All rates were reported for 19 geographical areas or ethnicities by sex, age group, and cancer type. The regional WSRs for children aged 0–14 years were compared with comparable data obtained in the 1980s.FindingsOf 532 invited cancer registries, 153 registries from 62 countries, departments, and territories met quality standards, and contributed data for the entire decade of 2001–10. 385 509 incident cases in children aged 0–19 years occurring in 2·64 billion person-years were included. The overall WSR was 140·6 per million person-years in children aged 0–14 years (based on 284 649 cases), and the most common cancers were leukaemia (WSR 46·4), followed by CNS tumours (WSR 28·2), and lymphomas (WSR 15·2). In children aged 15–19 years (based on 100 860 cases), the ASR was 185·3 per million person-years, the most common being lymphomas (ASR 41·8) and the group of epithelial tumours and melanoma (ASR 39·5). Incidence varied considerably between and within the described regions, and by cancer type, sex, age, and racial and ethnic group. Since the 1980s, the global WSR of registered cancers in children aged 0–14 years has increased from 124·0 (95% CI 123·3–124·7) to 140·6 (140·1–141·1) per million person-years.InterpretationThis unique global source of childhood cancer incidence will be used for aetiological research and to inform public health policy, potentially contributing towards attaining several targets of the Sustainable Development Goals. The observed geographical, racial and ethnic, age, sex, and temporal variations require constant monitoring and research.FundingInternational Agency for Research on Cancer and the Union for International Cancer Control.

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Serotype a is now the most common seen in the North American Arctic; highest rates occur in indigenous children.

nuvialuit in Canada's Western Arctic have been living by hunting and gathering for approximately 1,000 years. 1 Two activities define traditional Inuvialuit identity: harvesting of traditional foods (TF) and its redistribution or sharing. 2,3 Like most Indigenous peoples in North America, 4-6 Inuvialuit face extreme pressure to acculturate to Western values, including transitioning to a Western diet. 7,8 Traditional foods, defined as those harvested from the local environment, include animals obtained directly from the land or sea, which contributed largely to dietary intake and were vital to nutrition, health, and food security. However, drastic climate changes pose environmental stress on those animals (e.g., polar bear, seal and caribou) that are TF sources. 9,10 Foods that replace TF are mainly processed, high in sugar and fat, and much less nutrient-dense. This shift in diet has resulted in a decreased intake of many micronutrients 11-14 and is associated with increasing rates of obesity, diabetes, and other chronic disease in Indigenous peoples in the Arctic. 15,16 Prevalence of diabetes in Indigenous North Americans is 3-5 times that of the general population in Canada. 17 The prevalence of risk factors of diabetes, such as overweight and obesity, is higher among the Canadian Aboriginal population compared to the general population. 18,19 Consequently, there is an urgent need to develop a nutritional intervention program to improve dietary intake for chronic disease prevention. Despite the known effectiveness of risk reduction interventions for obesity, diabetes and other chronic diseases, 20 few nutritional intervention programs for Inuvialuit have been successful. Furthermore, there is little up-to-date data on Inuvialuit diet, particularly the diet during transition to a Western diet. The aims of this study were to: 1) characterize diet in Inuvialuit; 2) highlight foods and nutrients for a community-based multiinstitutional nutritional and lifestyle intervention program; and 3) develop a Quantitative Food Frequency Questionnaire (QFFQ) to evaluate the program and monitor nutrition transition in Inuvialuit.

Diet-related chronic diseases are highly prevalent among indigenous populations in the Canadian Arctic. A community-based, multi-institutional nutritional and lifestyle intervention-Healthy Foods North-was implemented to improve food-related psychosocial factors and behaviors among Inuit and Inuvialuit in four intervention communities (with two comparison communities) in Nunavut and the Northwest Territories, Canada, in 2008. The 12-month program was developed from theory (social cognitive theory and social ecological models), formative research, and a community participatory process. It included an environmental component to increase healthy food availability in local stores and activities consisting of community-wide and point-of-purchase interactive educational taste tests and cooking demonstrations, media (e.g., radio ads, posters, shelf labels), and events held in multiple venues, including recreation centers and schools. The intervention was evaluated using pre- and postassessments with 246 adults from intervention and 133 from comparison communities (311 women, 68 men; mean age 42.4 years; 78.3% retention rate). Outcomes included psychosocial constructs (healthy eating knowledge, self-efficacy, and behavioral intentions), frequency of healthy and unhealthy food acquisition, healthiness of commonly used food preparation methods, and body mass index (kg/m(2)). After adjustment for demographic, socioeconomic status, and body mass index variables, respondents living in intervention communities showed significant improvements in food-related self-efficacy (β = 0.15, p = .003) and intentions (β = 0.16, p = .001) compared with comparison communities. More improvements from the intervention were seen in overweight, obese, and high socioeconomic status respondents. A community-based, multilevel intervention is an effective strategy to improve psychosocial factors for healthy nutritional behavior change to reduce chronic disease in indigenous Arctic populations.