Trends in International Incidence of Pediatric Cancers in Children Under 5 Years of Age: 1988–2012

Abstract

Background Pediatric cancer incidence has been steadily increasing over the last several decades with the largest increases reported in infants. Few evaluations have looked at international pediatric cancer incidence trends in the youngest children. The aim of this analysis was to evaluate trends in cancer incidence in children under 5 years of age, overall and by type, using data from Cancer Incidence in 5 Continents (CI5) from 1988 to 2012 (CI5 volumes VII–XI). Methods Rates of cancers in children ages 0–4 years were extracted from registries available in CI5 from 1988 to 2012. To overcome small numbers in individual registries, numerators and denominators were aggregated within regions corresponding to the United Nations’ geoscheme. Average annual percent change (AAPC) was estimated using Poisson regression. Robust standard errors were used in all models to correct for overdispersion in some regions, and 95% Wald confidence intervals and P values were reported. The top five cancers by increasing AAPC were ranked within each region. Results Overall, in children under 5 years, increasing incidence was seen in multiple regions for acute lymphoblastic leukemia, acute myeloid leukemia, ependymal tumors, neuroblastoma, and hepatoblastoma. Hepatoblastoma had the largest AAPC in 11 out of 15 regions and showed an increase in all regions except southern Asia. Astrocytic tumors were the only cancer that decreased over the time period. Conclusions We evaluated 25 years of cancer incidence in children ages 0–4 years and observed increases in incidence for hepatoblastoma, leukemia, neuroblastoma, and ependymal tumors. Further etiologic evaluation will be required to explain these increases in incidence.

Global trends in incidence rates of childhood liver cancers: A systematic review and meta‐analysis

“…A recent report on trends in international incidence of pediatric cancers among children aged under 5 years reported increasing incidence rates for childhood HB from 1988 to 2012 in all regions except southern Asia (India, Iran) with the strongest increases being seen for countries classified as having high and very high human development index (HDI). 44 Their results indicated that HB was the fastest rising cancer globally for this age group, although no specific reasons for this pattern were presented, reflecting the generally poor understanding of childhood HB aetiology.…”

Diagnosis and treatment of infantile malignant solid tumors in beijing, China: A multicenter 10‐year retrospective study

“…However, this also contributed to the high proportion of RB and HB in this group of patients. Hubbard et al 9 evaluating 25 years of cancer incidence in children showed that the incidence of NB was increasing, while the incidence of germ cell tumors was declining. The occurrence of tumors also differed among ethnicities.…”

Hepatoblastoma surveillance in infants born with very low birth weight: Has the time come?

“…Between 1988 and 2012, hepatoblastoma was the fastestrising cancer globally in children <5 years. 5 It is more common in countries with a very high human development index, a statistical marker of relative affluence, where the incidence has changed from 0.8 to 5.6 per million. The overall estimated average annual percent change is 3.43 (CI 2.73-4.13).…”

“…The overall estimated average annual percent change is 3.43 (CI 2.73-4.13). 5 There is a popular assumption that overall improvements in neonatal care, leading to better survival of infants born with low birth weight, may be contributing to the several-fold increase in hepatoblastoma incidence in the developed world.…”