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Erdmann F, Hvidtfeldt UA, Dalton SO, Sørensen M, Raaschou-Nielsen O. Individual and neighbourhood socioeconomic measures and the risk of non-central nervous system solid tumours in children: A nationwide register-based case-control study in Denmark. Cancer Epidemiol 2021; 73:101947. [PMID: 33979714 DOI: 10.1016/j.canep.2021.101947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/28/2021] [Accepted: 05/02/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The aetiology for most solid tumours in childhood is largely unknown. The lack of evidence concerns also the relationship between socioeconomic position (SEP) and risk of childhood solid tumours other than in the central nervous system (CNS). We sought to access the association between individual and neighbourhood SEP measures and risk of childhood non-CNS solid tumours in Denmark and to evaluate whether associations varied by measure of SEP, time point of SEP assessment (during pregnancy versus before diagnosis) and tumour type. METHODS We conducted a nationwide case-control study based on Danish registry data. We identified all children born in 1980-2013 and diagnosed with a non-CNS solid tumour at ages 0-19 years (N = 1961) from the Danish Cancer Registry and sampled four individually matched controls per case using the Population Registry. We fitted conditional logistic regression models to estimate associations with register-based individual-level and neighbourhood-level SEP measures. RESULTS We observed a tendency of increased odd ratios (OR) in association with medium and high maternal income for most tumour types (e.g. OR for the highest income quintile and malignant bone tumours = 2.11; 95 % CI: 1.01, 4.38) and for parental education in association with higher education for some tumour types. For malignant epithelial neoplasms, higher parental education and income level were overall associated with an increased risk, e.g. OR = 1.63 (95 % CI: 1.00, 2.65) for the fourth group of maternal income during pregnancy. We found no risk pattern for neighbourhood SEP. CONCLUSION This large register-study with minimal risk of bias found a tendency of slightly to moderately increased risks for most childhood non-CNS solid tumours in association with higher maternal income and parental education. Future research examining the underlying mechanisms of these socioeconomic differences in non-CNS solid tumours as well as other childhood cancer types are warranted.
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Affiliation(s)
- Friederike Erdmann
- Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), Johannes Gutenberg University Mainz, Obere Zahlbacher Str. 69, 55131 Mainz, Germany.
| | - Ulla Arthur Hvidtfeldt
- Danish Cancer Society Research Center, Danish Cancer Society, Strandboulevarden 49, 2100 Copenhagen, Denmark
| | - Susanne Oksbjerg Dalton
- Danish Cancer Society Research Center, Danish Cancer Society, Strandboulevarden 49, 2100 Copenhagen, Denmark; Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Oncology & Palliative Care, Zealand University Hospital, Naestved, Denmark
| | - Mette Sørensen
- Danish Cancer Society Research Center, Danish Cancer Society, Strandboulevarden 49, 2100 Copenhagen, Denmark; Department of Natural Science and Environment, Roskilde University, Universitetsvej 1, P.O. Box 260, 4000 Roskilde, Denmark
| | - Ole Raaschou-Nielsen
- Danish Cancer Society Research Center, Danish Cancer Society, Strandboulevarden 49, 2100 Copenhagen, Denmark; Department of Environmental Science, Aarhus University, Frederiksborgvej 399, P.O. Box 358, 4000 Roskilde, Denmark
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2
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Jessop S, Ruhayel S, Sutton R, Youlden DR, Pearson G, Lu C, Milne S, Henderson MJ, Aitken JF, Kotecha RS, Revesz T. Are outcomes for childhood leukaemia in Australia influenced by geographical remoteness and Indigenous race? Pediatr Blood Cancer 2021; 68:e28945. [PMID: 33565233 DOI: 10.1002/pbc.28945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 01/04/2021] [Accepted: 01/20/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Presenting features, biology and outcome for childhood leukaemia are known to vary by ethnic origin, geographic location and socioeconomic group. This study aimed to compare presentation patterns, follow-up and clinical outcomes in Indigenous and non-Indigenous children with acute leukaemia in Australia, and to assess the impact of remoteness and area-based socioeconomic disadvantage on outcome. METHODS A retrospective review of children aged between 1 day and 18 years who were diagnosed with acute leukaemia in South Australia (SA), Northern Territory (NT) and Western Australia (WA) between 2009 and 2018 was performed. Data were collected from children treated at the Women's and Children's Hospital, Adelaide and Perth Children's Hospital. RESULTS Analysis of 455 children treated for acute leukaemia showed that children from remote/very remote localities had inferior overall survival (p = .004). Five-year overall survival was 91.7% (95% CI: 87.9-94.3%) for children with acute lymphoblastic leukaemia (ALL) and 69.8% (56.7-79.5%) for acute myeloid leukaemia (AML). A larger proportion of Indigenous children from SA/NT were diagnosed with AML compared to non-Indigenous children (60.0% vs. 14.4%, p = .001). Indigenous children were less likely to be enrolled on clinical trials (34.5% vs. 53.1%, p = .03) and more likely to be lost to follow-up (26.1% vs. 9.2%, p = .009). CONCLUSION Geographic remoteness of residence is associated with inferior overall survival for Australian children with leukaemia. Indigenous children with acute leukaemia suffer from disparities in outcomes. These findings provide evidence to guide national policy in supporting appropriate resource allocation to overcome the challenges faced by children within these groups.
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Affiliation(s)
- Sophie Jessop
- Department of Haematology and Oncology, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Sandra Ruhayel
- Department of Clinical Haematology, Oncology and Bone Marrow Transplantation, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Rosemary Sutton
- Children's Cancer Institute, Lowy Cancer Research Centre, University of New South Wales, Sydney, New South Wales, Australia.,School of Women and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Danny R Youlden
- Cancer Council Queensland, Brisbane, Queensland, Australia.,Menzies Health Research Institute, Griffith University, Gold Coast, Queensland, Australia
| | - Glenn Pearson
- Telethon Kids Cancer Centre, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Cynthia Lu
- Cancer Council Queensland, Brisbane, Queensland, Australia
| | - Suzanne Milne
- Department of Haematology and Oncology, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Michelle J Henderson
- Children's Cancer Institute, Lowy Cancer Research Centre, University of New South Wales, Sydney, New South Wales, Australia.,School of Women and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Joanne F Aitken
- Cancer Council Queensland, Brisbane, Queensland, Australia.,Menzies Health Research Institute, Griffith University, Gold Coast, Queensland, Australia.,Institute for Resilient Regions, University of Southern Queensland, Springfield, Queensland, Australia.,School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Rishi S Kotecha
- Department of Clinical Haematology, Oncology and Bone Marrow Transplantation, Perth Children's Hospital, Perth, Western Australia, Australia.,Telethon Kids Cancer Centre, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia.,School of Pharmacy and Biomedical Sciences, Curtin University, Perth, Western Australia, Australia
| | - Tom Revesz
- Department of Haematology and Oncology, Women's and Children's Hospital, Adelaide, South Australia, Australia.,MRD Team, University of Adelaide, Adelaide, South Australia, Australia
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Erdmann F, Hvidtfeldt UA, Feychting M, Sørensen M, Raaschou-Nielsen O. Is the risk of childhood leukaemia associated with socioeconomic measures in Denmark? A nationwide register-based case-control study. Int J Cancer 2020; 148:2227-2240. [PMID: 33210292 DOI: 10.1002/ijc.33402] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 10/28/2020] [Accepted: 11/09/2020] [Indexed: 01/11/2023]
Abstract
The aetiology of childhood leukaemia is poorly understood. Knowledge about differences in risk by socioeconomic status (SES) may enhance etiologic insights. We conducted a nationwide register-based case-control study to evaluate socioeconomic differences in the risk of childhood leukaemia in Denmark and to access whether associations varied by different measures of SES, time point of assessment, leukaemia type and age at diagnosis. We identified all cases of leukaemia in children aged 0 to 19 years, born and diagnosed between 1980 and 2013 from the Danish Cancer Registry (N = 1336) and sampled four individually matched controls per case (N = 5330). We used conditional logistic regression models for analysis. Medium and high level of parental education was associated with a higher risk of acute myeloid leukaemia (AML) in the offspring, mainly driven by children diagnosed at ages 0 to 4 years [odds ratio (OR) for high maternal education = 3.07; 95% confidence interval (CI): 1.44-6.55]. We also observed a modestly increased risk for lymphoid leukaemia (LL) in association with higher level of parental education, but only in children diagnosed at ages 5 to 19 years. Higher parental income was associated with an increased risk of LL but not AML among children aged 5 to 19 years at diagnosis (OR for high maternal income = 2.78; 95% CI: 1.32-5.89). Results for neighbourhood SES measures indicated null associations. Bias or under-ascertainment of cases among families with low income or basic education are unlikely to explain the observed socioeconomic differences. Future research addressing explicitly the underlying mechanisms of our results may help to enhance etiologic insights of the disease.
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Affiliation(s)
- Friederike Erdmann
- Division of Childhood Cancer Epidemiology, Institute for Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | | | - Maria Feychting
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Mette Sørensen
- Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark.,Department of Natural Science and Environment, Roskilde University, Roskilde, Denmark
| | - Ole Raaschou-Nielsen
- Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark.,Department of Environmental Science, Aarhus University, Roskilde, Denmark
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4
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Erdmann F, Hvidtfeldt UA, Sørensen M, Raaschou-Nielsen O. Socioeconomic differences in the risk of childhood central nervous system tumors in Denmark: a nationwide register-based case-control study. Cancer Causes Control 2020; 31:915-929. [PMID: 32767157 PMCID: PMC7458950 DOI: 10.1007/s10552-020-01332-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 07/24/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE Differences in the risk of childhood central nervous system (CNS) tumors by socioeconomic status (SES) may enhance etiologic insights. We conducted a nationwide register-based case-control study to evaluate socioeconomic differences in the risk of childhood CNS tumors in Denmark and examined whether associations varied by different SES measures, time points of assessment, specific tumor types, and age at diagnosis. METHODS We identified all children born between 1981 and 2013 and diagnosed with a CNS tumor at ages 0-19 years (n = 1,273) from the Danish Cancer Registry and sampled four individually matched controls per case (n = 5,086). We used conditional logistic regression models to estimate associations with individual-level and neighborhood-level socioeconomic measures. RESULTS We observed elevated risks of ependymoma and embryonal CNS tumors in association with higher parental education (odds ratios (ORs) of 1.6-2.1 for maternal or paternal high education and ependymoma) and higher risk of all tumor types in association with higher maternal income, e.g., OR 1.93; 95% CI 1.05-3.52 for high versus low income for astrocytoma and other gliomas. Associations were often stronger in children diagnosed at ages 5-19 years. We found little evidence for an association with neighborhood SES. CONCLUSION This large nationwide register study with minimal risk of bias showed that having parents with higher educational level and a mother with higher income was associated with a higher risk of childhood CNS tumors. Bias or under-ascertainment of cases among families with low income or basic education is unlikely to explain our findings.
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Affiliation(s)
- Friederike Erdmann
- Danish Cancer Society Research Center, Danish Cancer Society, Strandboulevarden 49, 2100, Copenhagen, Denmark.
- German Childhood Cancer Registry, Institute for Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Obere Zahlbacher Str. 69, 55131, Mainz, Germany.
| | - Ulla Arthur Hvidtfeldt
- Danish Cancer Society Research Center, Danish Cancer Society, Strandboulevarden 49, 2100, Copenhagen, Denmark
| | - Mette Sørensen
- Danish Cancer Society Research Center, Danish Cancer Society, Strandboulevarden 49, 2100, Copenhagen, Denmark
- Department of Natural Science and Environment, Roskilde University, Universitetsvej 1, P.O. Box 260, 4000, Roskilde, Denmark
| | - Ole Raaschou-Nielsen
- Danish Cancer Society Research Center, Danish Cancer Society, Strandboulevarden 49, 2100, Copenhagen, Denmark
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, P.O. Box 358, 4000, Roskilde, Denmark
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Jahan F, Duncan EW, Cramb SM, Baade PD, Mengersen KL. Augmenting disease maps: a Bayesian meta-analysis approach. ROYAL SOCIETY OPEN SCIENCE 2020; 7:192151. [PMID: 32968502 PMCID: PMC7481717 DOI: 10.1098/rsos.192151] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 07/03/2020] [Indexed: 06/11/2023]
Abstract
Analysis of spatial patterns of disease is a significant field of research. However, access to unit-level disease data can be difficult for privacy and other reasons. As a consequence, estimates of interest are often published at the small area level as disease maps. This motivates the development of methods for analysis of these ecological estimates directly. Such analyses can widen the scope of research by drawing more insights from published disease maps or atlases. The present study proposes a hierarchical Bayesian meta-analysis model that analyses the point and interval estimates from an online atlas. The proposed model is illustrated by modelling the published cancer incidence estimates available as part of the online Australian Cancer Atlas (ACA). The proposed model aims to reveal patterns of cancer incidence for the 20 cancers included in ACA in major cities, regional and remote areas. The model results are validated using the observed areal data created from unit-level data on cancer incidence in each of 2148 small areas. It is found that the meta-analysis models can generate similar patterns of cancer incidence based on urban/rural status of small areas compared with those already known or revealed by the analysis of observed data. The proposed approach can be generalized to other online disease maps and atlases.
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Affiliation(s)
- Farzana Jahan
- School of Mathematical Science, ARC Centre of Excellence for Mathematical and Statistical Frontiers, Queensland University of Technology, Queensland, Australia
| | - Earl W. Duncan
- School of Mathematical Science, ARC Centre of Excellence for Mathematical and Statistical Frontiers, Queensland University of Technology, Queensland, Australia
| | | | - Peter D. Baade
- Cancer Council Queensland, Brisbane, Queensland, Australia
| | - Kerrie L. Mengersen
- School of Mathematical Science, ARC Centre of Excellence for Mathematical and Statistical Frontiers, Queensland University of Technology, Queensland, Australia
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Ologbenla A, Hu M, Hajizadeh M. Socioeconomic status and incidence of pediatric leukemia in Canada: 1992-2010. Cancer Epidemiol 2019; 61:14-22. [PMID: 31103934 DOI: 10.1016/j.canep.2019.04.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 04/03/2019] [Accepted: 04/26/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Leukemia is the most common cancer among Canadian children, representing about a third of pediatric cancers in Canada and is responsible for about one-third of pediatric cancer deaths. Understanding the effect of socioeconomic status (SES) on pediatric leukemia incidence provides valuable information for cancer control and interventions in Canada. METHODS Using a linked data from the Canadian Cancer Registry (CCR), Canadian Census of Population (CCP) and National Household Survey (NHS) we aimed to quantify socioeconomic inequalities in the incidence of pediatric leukemia from 1992 to 2010. We used the concentration index (C) approach to quantify income- and education-related inequalities in the incidence of pediatric leukemia over time. RESULTS Though there were fluctuations in incidence over the study period, our results showed that the total incidence of pediatric leukemia in Canada was generally consistent from 1992 to 2010. Incidence rate of 47 per 1,000,000 as at 1992 rose to 57 per 1,000,000 in 2010. The estimated values of the C over the study period failed to show any significant association between pediatric leukemia incidence and household income or education status. CONCLUSIONS Although pediatric leukemia incidence is not rising significantly, it is not reducing significantly either. The incidence of pediatric leukemia showed no significant association with socioeconomic status. Future cancer control interventions should focus more on mitigating risk factors that are independent of socioeconomic status.
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Affiliation(s)
| | - Min Hu
- School of Health Administration, Dalhousie University, Halifax, Canada
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7
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Erdmann F, Feychting M, Mogensen H, Schmiegelow K, Zeeb H. Social Inequalities Along the Childhood Cancer Continuum: An Overview of Evidence and a Conceptual Framework to Identify Underlying Mechanisms and Pathways. Front Public Health 2019; 7:84. [PMID: 31106186 PMCID: PMC6492628 DOI: 10.3389/fpubh.2019.00084] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 03/26/2019] [Indexed: 12/13/2022] Open
Abstract
Inequalities in health according to social conditions are regarded as unnecessary and unjust. There is a large body of evidence on inequalities in adult cancer, observable throughout the societies on a national level as well as on a global scale. Socioeconomic influences on health matter at all ages including childhood, for which childhood cancer is the leading cause of disease related death in high-income countries (HICs). Substantial differences in the reported incidence of childhood cancers have been observed globally by socioeconomic development of a population. This is reflected in the higher incidence rates reported for HICs, particularly for acute lymphoblastic leukemia, and for cancer in infants (below 1 year), compared to low- and middle-income countries (LMICs). Considerable inequalities between populations and degree of socioeconomic development are also noted for survival from childhood cancer, with substantially lower survival rates seen in most LMICs compared to HICs. With respect to inequalities by socioeconomic position (SEP) within countries, findings of an association between SEP and childhood cancer risk are diverse and limited to studies from HICs. On the contrary, observations on social inequalities in survival within countries are accumulating and indicate that survival inequalities do not only concern resource-poor countries but also high-income populations including European countries. In turn, a childhood cancer diagnosis in itself may have implications on the parents' socioeconomic situation as well as on the later socioeconomic life after having survived the disease. The underlying mechanisms and causal pathways of these empirically demonstrated social inequalities are poorly understood, although it is of significant public health relevance for any actions or strategies to reduce childhood cancer-related inequity. We propose a conceptual framework on potential underlying mechanism and pathways specifically addressing social inequalities in childhood cancer and after childhood cancer to (i) illustrate potential pathways by which social determinants may create health inequities at different points of the childhood cancer continuum; (ii) illustrate potential pathways by which a childhood cancer diagnosis may impact the socioeconomic situation of the concerned family or the later life of a childhood survivor; and (iii) point out how major determinants may relate to each other.
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Affiliation(s)
- Friederike Erdmann
- Section of Environment and Radiation, International Agency for Research on Cancer (IARC), Lyon, France
- Department of Prevention and Evaluation, Leibniz - Institute for Prevention Research and Epidemiology - BIPS GmbH, Bremen, Germany
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Maria Feychting
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Hanna Mogensen
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kjeld Schmiegelow
- Department of Pediatrics and Adolescent Medicine, University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Hajo Zeeb
- Department of Prevention and Evaluation, Leibniz - Institute for Prevention Research and Epidemiology - BIPS GmbH, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
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8
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González García H, Garrote Molpeceres R, Urbaneja Rodríguez E, Gutiérrez Meléndez P, Herráiz Cristóbal R, Pino Vázquez MA. Differences in incidence and survival to childhood cancer between rural and urban areas in Castilla y León, Spain (2003-2014): A Strobe-compliant study. Medicine (Baltimore) 2018; 97:e12797. [PMID: 30313108 PMCID: PMC6203519 DOI: 10.1097/md.0000000000012797] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The aim of this study is to describe childhood cancer incidence and survival in Castilla y León (Spain) for the period 2003 to 2014 and to explore differences between rural and urban areas.We made a cohort study in the childhood population of our region for the period of years referred before. Age-adjusted incidence rates to the world standard population (ASRw) were calculated by direct method, and their comparisons were made using incidence rate rations. Survival proportions were calculated by Kaplan-Meier method and their comparisons with log-rank test. The median childhood population less than 15 years old was 296,776 children. A total of 615 cases were recorded from the population-based Childhood Cancer Registry, including all malignant and benign tumors of the central nervous system.Age-standardized incidence rates for all cancers were 176.6 per million. Leukemia incidence rates were highest in rural areas (51.08/million) than in urban areas (33.65/million; P = .018), and by age groups; these differences only remained at age 0 to 4 years with higher rural leukemia incidence (67.13/million) than in urban areas (39.32/million; P = .05). There were no statistically significant differences between rural and urban areas for lymphomas, central nervous system, and all other malignant solid tumors grouped. The 5-year overall survival rate for all patients was 84%, similar to other developed countries, with greater survival in rural areas (88%) compared with urban areas (80%; P = .033). The analysis by tumor groups showed a greater survival rate in rural areas for all the groups, although these differences only reached statistical significance in the group of leukemias, with a survival rate of 90% for rural areas compared with 76% for urban areas (P = .01). Analyzing survival rate by age groups in leukemias only significant survival differences at 10 to 14 years were encountered.We found a higher incidence of leukemia in girls, mainly in rural areas, and also a better survival rate in children diagnosed with leukemia belonging to this population area. Future studies that analyze these facts in similar populations can help us clarify what genetic, epigenetic and environmental factors influence our population and are responsible for these findings.
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Affiliation(s)
- Hermenegildo González García
- Division of Haematology/Oncology, Department of Pediatrics, Valladolid Clinic University Hospital, C/ Ramón y Cajal
| | - Rebeca Garrote Molpeceres
- Division of Haematology/Oncology, Department of Pediatrics, Valladolid Clinic University Hospital, C/ Ramón y Cajal
| | - Elena Urbaneja Rodríguez
- Division of Haematology/Oncology, Department of Pediatrics, Valladolid Clinic University Hospital, C/ Ramón y Cajal
| | - Pilar Gutiérrez Meléndez
- Health Public Observatory of Junta de Castilla y León, Consejería de Sanidad, Paseo de Zorrilla, Valladolid, Spain
| | - Raquel Herráiz Cristóbal
- Division of Haematology/Oncology, Department of Pediatrics, Valladolid Clinic University Hospital, C/ Ramón y Cajal
| | - María Asunción Pino Vázquez
- Division of Haematology/Oncology, Department of Pediatrics, Valladolid Clinic University Hospital, C/ Ramón y Cajal
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9
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Ye X, Torabi M, Lix LM, Mahmud SM. Time and spatial trends in lymphoid leukemia and lymphoma incidence and survival among children and adolescents in Manitoba, Canada: 1984-2013. PLoS One 2017; 12:e0175701. [PMID: 28430788 PMCID: PMC5400229 DOI: 10.1371/journal.pone.0175701] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 03/30/2017] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES To test for time and spatial trends in lymphoid malignancies, including lymphoid leukemia (LL), Hodgkin lymphoma (HL), and non-Hodgkin lymphoma (NHL), in children and adolescents in the province of Manitoba, Canada. METHODS Incident cases diagnosed between 1984 and 2013 were identified from the Manitoba Cancer Registry. We assessed time trends in age-standardized incidence rates using joinpoint regression and in 5-year relative survival using Poisson regression model. Kulldorff's scan method was used to assess spatial variation and clustering. RESULTS Age-standardized incidence rates (per million person-years) in males and females were 34.0 (95% confidence interval [CI] 28.9-39.1) and 26.2 (95% CI 21.5-30.7) for LL, 10.5 (95% CI 7.7-13.3) and 12.5 (95% CI 9.4-15.7) for HL, 12.5 (95% CI 9.3-15.4) and 7.7 (95% CI 5.2-10.2) for NHL (except for Burkitt lymphomas), and 3.2 (95% CI 1.6-4.7) and 1.5 (95% CI 0.4-2.5) for Burkitt lymphomas. Age- and sex- standardized LL incidence rate increased 1.4% (95% CI 0.3%-2.5%) per year, while the changes for HL and NHL incidence rates were not statistically significant. There were geographic differences in age-standardized incidence rates for LL, HL, and NHL and spatial clusters were detected in southern part of the province. Five-year relative survival has improved over time and there was no difference between rural and urban areas. CONCLUSIONS Lymphoid leukemia incidence rate increased over time and varied by geographic area. Further research should examine the factors contributing to these trends.
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Affiliation(s)
- Xibiao Ye
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- George & Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Mahmoud Torabi
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Lisa M. Lix
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- George & Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Salaheddin M. Mahmud
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- George & Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, Manitoba, Canada
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10
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Marquant F, Goujon S, Faure L, Guissou S, Orsi L, Hémon D, Lacour B, Clavel J. Risk of Childhood Cancer and Socio-economic Disparities: Results of the French Nationwide Study Geocap 2002-2010. Paediatr Perinat Epidemiol 2016; 30:612-622. [PMID: 27555468 DOI: 10.1111/ppe.12313] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Socio-economic status is related to many life style and environmental factors, some of which have been suggested to influence the risk of childhood cancer. Studies requiring subject participation are usually hampered by selection of more educated parents. To prevent such bias, we used unselected nationwide Geographical Information System (GIS)-based registry data, to investigate the influence of socio-economic disparities on the risk of childhood cancer. METHODS The Geocap study included all French residents diagnosed with cancer aged up to 15 years over the period 2002-2010 (15 111 cases) and 45 000 contemporaneous controls representative of the childhood population. Area socio-economic characteristics used to calculate the European Deprivation Index (EDI) were based on census data collected on the fine scale of the Merged Islet for Statistical Information (IRIS). RESULTS Overall, the risk of acute lymphoblastic leukaemia (ALL) was lower in the most deprived quintile than in the other quintiles of EDI (ORQ5vs<Q5 0.80 (95% confidence interval (CI) 0.73, 0.88)). The odds ratio for all the other cancers taken together was close to the null (ORQ5vs<Q5 0.99 (95% CI 0.94, 1.04)). CONCLUSION Living in the most deprived areas was inversely associated with the risk of ALL in childhood. There was no indication that the risk of childhood cancer of any site could be increased by deprivation. Life style or environmental factors potentially underlying the association need further investigation.
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Affiliation(s)
- Fabienne Marquant
- Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS), Epidemiology of childhood and adolescent cancers research group (EPICEA), INSERM, UMR 1153, Paris Descartes University, Villejuif, France
| | - Stéphanie Goujon
- Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS), Epidemiology of childhood and adolescent cancers research group (EPICEA), INSERM, UMR 1153, Paris Descartes University, Villejuif, France.,French National Registry of Childhood Haematological Malignancies (NRCH), Villejuif, France
| | - Laure Faure
- Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS), Epidemiology of childhood and adolescent cancers research group (EPICEA), INSERM, UMR 1153, Paris Descartes University, Villejuif, France.,French National Registry of Childhood Haematological Malignancies (NRCH), Villejuif, France
| | - Sandra Guissou
- French National Registry of Childhood Solid Tumours (NRCST), Vandoeuvre-les-Nancy, France
| | - Laurent Orsi
- Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS), Epidemiology of childhood and adolescent cancers research group (EPICEA), INSERM, UMR 1153, Paris Descartes University, Villejuif, France
| | - Denis Hémon
- Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS), Epidemiology of childhood and adolescent cancers research group (EPICEA), INSERM, UMR 1153, Paris Descartes University, Villejuif, France
| | - Brigitte Lacour
- French National Registry of Childhood Solid Tumours (NRCST), Vandoeuvre-les-Nancy, France
| | - Jacqueline Clavel
- Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS), Epidemiology of childhood and adolescent cancers research group (EPICEA), INSERM, UMR 1153, Paris Descartes University, Villejuif, France.,French National Registry of Childhood Haematological Malignancies (NRCH), Villejuif, France
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Moore MA. Overview of Cancer Registration Research in the Asian Pacific from 2008-2013. Asian Pac J Cancer Prev 2013; 14:4461-84. [DOI: 10.7314/apjcp.2013.14.8.4461] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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