title: Childhood cancers in Chennai, India, 1990-2001: incidence and survival.
abstract: Childhood cancers (age at diagnosis: 0-14 years) comprise a variety of malignancies, with incidence varying worldwide by age, sex, ethnicity and geography, that provide insights into cancer etiology. A total of 1,334 childhood cancers registered in population-based cancer registry, Chennai, India, during 1990-2001 and categorized by International Classification of Childhood Cancer norms formed the study material. Cases included for survival analysis were 1,274 (95.5%). Absolute survival was calculated by actuarial method. Cox proportional hazard model was used to elicit the prognostic factors for survival. The age-standardized rates for all childhood cancers together were 127 per million boys and 88 per million girls. A decreasing trend in incidence rates with increasing 5-year age groups was observed in both sexes. The top 5 childhood cancers were the same among boys and girls: leukemias, lymphomas, central nervous system neoplasms, retinoblastomas and renal tumors. The highest 5-year absolute survival was observed in Hodgkin's disease (65%) followed by Wilm's tumor (64%), retinoblastomas (48%), non-Hodgkin's lymphomas (47%), osteosarcomas (44%), acute lymphoid leukemia and astrocytoma (39%). Multifactorial analysis of age at diagnosis and sex showed no differences in the risk of dying for all childhood cancers. Completeness of treatment and type of hospital combination emerged as a prognostic factor for survival for all childhood cancers together (p < 0.001), acute lymphoid leukemia (p < 0.001) and non-Hodgkin's lymphoma (p = 0.04). A Childhood Cancer Registry with high-resolution data collection is advocated for in-depth analysis of variation in incidence and survival.
authors.affiliation: Division of Epidemiology and Cancer Registry, Cancer Institute (WIA), Chennai, Tamil Nadu, India. iarcsurvival@yahoo.co.uk
authors.forename: Rajaraman
authors.initials: R
authors.lastname: Swaminathan
authors.forename: Ranganathan
authors.initials: R
authors.lastname: Rama
authors.forename: Viswanathan
authors.initials: V
authors.lastname: Shanta
mesh_terms: D000206:Actuarial Analysis; D000293:Adolescent; D017677:Age Distribution; D016543:Central Nervous System Neoplasms / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007223:Infant; D007680:Kidney Neoplasms / Q000453:epidemiology; D007938:Leukemia / Q000453:epidemiology; D008223:Lymphoma / Q000453:epidemiology; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology; D008297:Male; D015999:Multivariate Analysis; D009369:Neoplasms / Q000453:epidemiology* / Q000401:mortality; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000453:epidemiology; D011379:Prognosis; D016016:Proportional Hazards Models; D012042:Registries; D012175:Retinoblastoma / Q000453:epidemiology; D016019:Survival Analysis; D015996:Survival Rate; D013997:Time Factors