title: Incidence Patterns and Trends of non-Central Nervous System Solid Tumours in Children and Adolescents. A Collaborative Study of the Spanish Population Based Cancer Registries.
abstract: OBJECTIVE
  To describe incidence patterns and trends in children (0-14 years) and adolescents (15-19 age-range) with solid tumours, except those of central nervous system (CNS), in Spain.
  
  
  METHODS
  Cases were drawn from eleven Spanish population-based cancer registries. Incidence was estimated for the period 1983-2007 and trends were evaluated using Joinpoint regression analysis.
  
  
  RESULTS
  The studied tumour groups accounted for 36% of total childhood cancers and 47.6% of those diagnosed in adolescence with annual rates per million of 53.5 and 89.3 respectively. In children 0 to 14 years of age, Neuroblastoma (NB) was the commonest (7.8%) followed by Soft-tissue sarcomas (STS) (6.3%), bone tumours (BT) (6.2%) and renal tumours (RT) (4.5%). NB was the most frequently diagnosed tumour before the 5th birthday, while STS and BT were the commonest at 5-9 years of age, and BT and Carcinoma and other epithelial tumours (COET) at 10-14. COET presented the highest incidence in adolescents, followed by germ-cell tumours (GCT), BT and STS. These four diagnostic groups accounted for 94% of total non-CNS solid tumours, in adolescents. Overall incidence rates increased significantly in children up to 1996 with an annual percentage change (APC) of 2.6% (95%CI: 1.7; 3.6). NB and COET showed significant time trend (APCs: 1.4% and 3.8% respectively) while other tumour groups such as RT, STS, BT or GCT had no significant changes over time. A significant increase was present in NB under the age of 5 and in BT and STS in children aged 10-14 years. In adolescents there were significant increases for all tumours combined (APC=2.7; 95%CI: 1.8-3.6) and for STS, GCT and COET (APCs: 3.2%, 4.4% and 3.5% respectively), while other tumour groups such as hepatic tumours, BT or thyroid carcinomas showed a decreasing trend or no increase.
  
  
  CONCLUSIONS
  Overall, the incidence of the studied cancers in children increased along the period 1983-1996 with no posterior significant rise, while the incidence in adolescents increased significantly over the whole period 1983-2007. Several specific tumour groups showed significant rises or decrements in childhood or adolescence, although the small number of cases precludes showing significant trends or inflexion points.
authors.affiliation: 1. Public Health Division of Gipuzkoa, Basque Health Department, Spain. Avda de Navarra 4, 20008-San Sebastian, Spain.; 2. CIBER de Epidemiología y Salud Pública (CIBERESP), Spain.
authors.forename: Nerea
authors.initials: N
authors.lastname: Larrañaga
authors.affiliation: 3. Escuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria ibs.GRANADA. Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain.; 2. CIBER de Epidemiología y Salud Pública (CIBERESP), Spain.
authors.forename: M José
authors.initials: MJ
authors.lastname: Sanchez
authors.affiliation: 4. Navarre Public Health Institute, Pamplona, Spain. C) Leyre 15, Pamplona, 31003, Spain.; 5. Navarra Institute for Health Research (IdiSNA) Pamplona, Spain; 2. CIBER de Epidemiología y Salud Pública (CIBERESP), Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Ardanaz
authors.affiliation: 6. Spanish Registry of Childhood Tumours (RTI-SEHOP), Spanish Society of Paediatric Haematology and Oncology, and University of Valencia, Valencia, Spain. Avda. Blasco Ibáñez, 15. 46010-Valencia.
authors.forename: Saray
authors.initials: S
authors.lastname: Felipe
authors.affiliation: 7. Epidemiology Unit and Girona Cancer Registry (Oncology Coordination Plan). Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Girona Biomedical Research Institute, Girona, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Marcos-Gragera
authors.affiliation: 8. Registre de càncer de Mallorca. Direcció General de Salut Pública. Illes Balears, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Ramos
authors.affiliation: 9. Tarragona Cancer Registry, Fundació Lliga per a la Investigació i Prevenció del Càncer. IISPV, Reus. Spain.
authors.forename: Marià
authors.initials: M
authors.lastname: Carulla
authors.affiliation: 10. Department of Epidemiology, Murcia Regional Health Authority, IMIB-Arrixaca Murcia, Spain.; 2. CIBER de Epidemiología y Salud Pública (CIBERESP), Spain.
authors.forename: M Dolores
authors.initials: MD
authors.lastname: Chirlaque
authors.affiliation: 11. Asturias Cancer Registry. Public Health Directorate, Asturias (Spain).
authors.forename: Marcial V
authors.initials: MV
authors.lastname: Argüelles
authors.affiliation: 2. CIBER de Epidemiología y Salud Pública (CIBERESP), Spain.; 12. Instituto Aragonés de Ciencias de la Salud. Zaragoza, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Martos
authors.affiliation: 13. Albacete Cancer Registry, Health and Social Welfare Authority, Castilla-La Mancha, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Mateo
authors.affiliation: 6. Spanish Registry of Childhood Tumours (RTI-SEHOP), Spanish Society of Paediatric Haematology and Oncology, and University of Valencia, Valencia, Spain. Avda. Blasco Ibáñez, 15. 46010-Valencia.; 14. RTICC-Spanish Cancer Research Network, ISCiii, RD12/0036/0053, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Peris-Bonet
keywords: Spain.; adolescents; cancer; childhood; incidence; population-based study; solid tumour