title: Childhood cancer incidence and survival in Spain.
abstract: BACKGROUND
  This article affords an overview of the patterns and time trends of childhood cancer incidence (1983-2002) and survival (1991-2002) in Spain.
  
  
  METHODS
  A population-based study was conducted, including 5936 cases for incidence and 3257 for survival analyses. Differences in incidence were tested with the standardised incidence ratio. Trends were analysed for all tumours, and for all malignant, haematological, central nervous system (CNS) (all and only malignant) and other solid tumours. Incidence trends were analysed using Poisson and Bayesian joinpoint models. Observed, relative and age-adjusted survival rates were calculated, and trends were tested using the log-rank test.
  
  
  RESULTS
  The incidence pattern in Spain was similar to that in Europe. Rates, both overall and for leukaemias, lymphomas, CNS, soft tissue and, remarkably, for sympathetic nervous system and bone tumours, were high. Upward incidence trends were present for all tumour groups. All groups, except solid tumours (excluding CNS), displayed a change-point centred around 1990-95, after which the trend stopped rising. Five-year survival increased significantly across the period for all groups, except for CNS tumours. Recent survival results were in line with Italy, the UK and the European average.
  
  
  CONCLUSIONS
  To confirm these results, ongoing surveillance of incidence and survival trends, and studies targeting specific tumours are called for.
authors.affiliation: Spanish National Childhood Cancer Registry (RNTI-SEHOP), Spanish Society of Paediatric Haematology and Oncology, and University of Valencia, Valencia, Spain. rafael.peris@uv.es
authors.forename: R
authors.initials: R
authors.lastname: Peris-Bonet
authors.forename: D
authors.initials: D
authors.lastname: Salmerón
authors.forename: M A
authors.initials: MA
authors.lastname: Martínez-Beneito
authors.forename: J
authors.initials: J
authors.lastname: Galceran
authors.forename: R
authors.initials: R
authors.lastname: Marcos-Gragera
authors.forename: S
authors.initials: S
authors.lastname: Felipe
authors.forename: V
authors.initials: V
authors.lastname: González
authors.forename: J
authors.initials: J
authors.lastname: Sánchez de Toledo Codina
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009369:Neoplasms / Q000453:epidemiology* / Q000401:mortality; D012042:Registries; D013030:Spain / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends*