title: Incidence of childhood leukemia in Yogyakarta, Indonesia, 1998-2009.
abstract: BACKGROUND
  In most developing countries, incidence data for childhood cancers are less reliable, because very few population-based registries exist. The aim of this study was to present the epidemiology of childhood leukemia in the Dr. Sardjito Hospital (DSH) region, which catchment area extends beyond the boundaries of the Yogyakarta Special Province (YSP).
  
  
  METHODS
  Health records of children, 0-14 years of age, who were diagnosed with leukemia between January 1998 and December 2009, were reviewed. Diagnosis of leukemia was confirmed by morphological and histochemical examination of marrow samples.
  
  
  RESULTS
  The estimated average annual incidence rate (AAIR) of childhood acute leukemia in DSH was 46.2 per million per year. Interestingly, the annual incidence rate (AIR) of childhood acute leukemia from the catchment area of DSH significantly increased from 35 in 1999 to 70 in 2009 (ANOVA, P = 0.003). The YSP population data, analyzed separately, showed an increase in AIR from 15.7 to 32.9 (ANOVA, P = 0.325) and an AAIR of 28.8. Remarkably, a relatively high frequency (25.5% in DSH and 27.7% in YSP) of children with AML was found in the group of acute leukemias.
  
  
  CONCLUSIONS
  The DSH incidence calculations may be overestimated due to an underestimation of the population number. Since the population count for YSP is more precise, the data of YSP were used for comparison with developed countries. AAIR of ALL (20.8) is relatively low compared to Western countries (22.4-37.9). The AAIR of AML (8.0) is similar to Western countries (5.0-8.0) resulting a relatively high percentage of AML versus ALL (27.7%) in YSP.
authors.affiliation: Pediatric Hematology Oncology Division, Department of Pediatrics, Dr. Sardjito Hospital, Medical Faculty, Universitas Gadjah Mada, Yogyakarta, Indonesia. e.supriyadi@yahoo.co.id
authors.forename: Eddy
authors.initials: E
authors.lastname: Supriyadi
authors.forename: Pudjo H
authors.initials: PH
authors.lastname: Widjajanto
authors.forename: Ignatius
authors.initials: I
authors.lastname: Purwanto
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Cloos
authors.forename: Anjo J P
authors.initials: AJ
authors.lastname: Veerman
authors.forename: Sutaryo
authors.initials: S
authors.lastname: Sutaryo
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007214:Indonesia / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D007938:Leukemia / Q000453:epidemiology*; D008297:Male