Childhood and adolescent cancer in Spain: mortality time trends 1956-1990.
Using log-linear Poisson modelling, trends in childhood cancer mortality among the population under 20 years of age in Spain are described over the 35-year period from 1956 to 1990. Overall cancer mortality and seven specific sites were considered: all leukaemias, Hodgkin's disease, non-Hodgkin's lymphomas, malignant brain tumours, kidney cancer, malignant bone neoplasms, and a broad category of ill-defined tumours. An age-period-cohort model was used to analyse the influence of age, period of death and birth cohort. Recent trends were estimated by restricting analysis to the last three 5-year periods. In general, mortality began to decline at the beginning of the 1970s, with reductions of 36% in males and 45% in females being registered between 1966-1970 and 1986-1990. The use of age-period-cohort models revealed an initially rising period effect attributable to diagnostic advances. The decline in mortality in post-1965 generations and the final downturn in the period effect are both most certainly a consequence of the remarkable progress achieved in the treatment of such tumours. During the final 15 years, there was a relative decline in mortality of approximately 20% every 5 years. However, in the case of malignant renal tumours in males and malignant bone tumours and non-Hodgkin's lymphomas in both sexes the situation remained stable.
Cancer Epidemiology Unit, National Centre of Epidemiology, Carlos III Institute of Health, Madrid, Spain.
M
M
Pollán
G
G
López-Abente
M
M
Ruiz-Tovar
M V
MV
Martínez de Aragón
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001859:Bone Neoplasms / Q000401:mortality; D001932:Brain Neoplasms / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D015988:Cohort Effect; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007680:Kidney Neoplasms / Q000401:mortality; D007938:Leukemia / Q000401:mortality; D008223:Lymphoma / Q000401:mortality; D008297:Male; D009026:Mortality / Q000639:trends; D009369:Neoplasms / Q000401:mortality*; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology