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Int J Cancer. 2018 May 15;142(10):1977-1985. doi: 10.1002/ijc.31222. Epub 2017 Dec 29.

Neuroblastoma among children in Southern and Eastern European cancer registries: Variations in incidence and temporal trends compared to US.

Author information

1
Department of Hygiene, Epidemiology and Medical Statistics Medical School, National and Kapodistrian University of Athens, Athens, Greece.
2
Department of Pediatric Hematology-Oncology, "Pan. & Agl. Kyriakou" Children's Hospital, Athens, Greece.
3
Pediatric Hematology/Oncology Unit, First Department of Pediatrics, University of Athens, "Agia Sofia" Children's Hospital, Athens, Greece.
4
Department of Pediatric Hematology-Oncology, "Agia Sofia" Children's Hospital, Athens, Greece.
5
Department of Pediatric Hematology and Oncology, Hippokration Hospital, Thessaloniki, Greece.
6
2nd Hematology Oncology Unit, 2nd Pediatric Department, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece.
7
Department of Pediatric Hematology-Oncology, University of Crete, Heraklion, Greece.
8
Department of Pediatric Hematology-Oncology, "Mitera" Children's Hospital, Athens, Greece.
9
North Region Cancer Registry of Portugal (RORENO), Portuguese Institute of Oncology, Porto, Portugal.
10
Registo Oncológico Regional do Centro (ROR-Centro), Instituto Português de Oncologia de Coimbra Francisco Gentil, E.P.E., Coimbra, Portugal.
11
The Oncology Institute "Prof. Dr. Ion Chiricuţă", Cluj-Napoca, Romania.
12
Health Monitoring Unit, Ministry of Health, Nicosia, Cyprus.
13
Department for Policy in Health - Health Information and Research, Malta National Cancer Registry, Pieta, Malta.
14
Izmir Cancer Registry, Izmir Hub, Izmir and Hacettepe, University Institute of Public Health, Ankara, Turkey.
15
Regional Cancer Registry, National Institute of Public Health, Iasi, Romania.
16
Croatian Institute of Public Health, Croatian National Cancer Registry, Zagreb, Croatia.
17
Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia.
18
Wielkopolskie Centrum Onkologii, Poznan University of Medical Sciences, Poznan, Poland.
19
Cancer Registry of Slovenia, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
20
Belarusian Research Center for Paediatric Oncology, Haematology and Immunology, Childhood Cancer Subregistry of Belarus, Minsk, Belarus.
21
National Cancer Registry of Ukraine, National Institute of Cancer, Kiev, Ukraine.
22
Fourth Department of Pediatrics, Medical School, General Hospital "Papageorgiou", Aristotle University of Thessaloniki, Thessaloniki, Greece.
23
International Agency for Research on Cancer, World Health Organization, Lyon, France.

Abstract

Neuroblastoma comprises the most common neoplasm during infancy (first year of life). Our study describes incidence of neuroblastoma in Southern-Eastern Europe (SEE), including - for the first time - the Nationwide Registry for Childhood Hematological Malignancies and Solid Tumors (NARECHEM-ST)/Greece, compared to the US population, while controlling for human development index (HDI). Age-adjusted incidence rates (AIR) were calculated for 1,859 childhood (0-14 years) neuroblastoma cases, retrieved from 13 collaborating SEE registries (1990-2016), and were compared to those of SEER/US (N = 3,166; 1990-2012); temporal trends were assessed using Poisson regression and Joinpoint analyses. The overall AIR was significantly lower in SEE (10.1/million) compared to SEER (11.7 per million); the difference was maximum during infancy (43.7 vs. 53.3 per million, respectively), when approximately one-third of cases were diagnosed. Incidence rates of neuroblastoma at ages <1 and 1-4 years were positively associated with HDI, whereas lower median age at diagnosis was correlated with higher overall AIR. Distribution of primary site and histology was similar in SEE and SEER. Neuroblastoma was slightly more common among males compared to females (male-to-female ratio: 1.1), mainly among SEE infants. Incidence trends decreased in infants in Slovenia, Cyprus and SEER and increased in Ukraine and Belarus. The lower incidence in SEE compared to SEER, especially in infants living in low HDI countries possibly indicates a lower level of overdiagnosis in SEE. Hence, increases in incidence rates in infancy noted in some subpopulations should be carefully monitored to avoid the unnecessary costs health impacts of tumors that could potentially spontaneously regress.

KEYWORDS:

children; incidence; neuroblastoma; overdiagnosis; time trends

PMID:
29250786
DOI:
10.1002/ijc.31222
[Indexed for MEDLINE]

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