title: Childhood leukemia incidence in California: High and rising in the Hispanic population.
abstract: High rates of childhood leukemia incidence have been reported in Latin America and among Hispanic children in the United States. California's large Hispanic population affords an important opportunity to perform a detailed analysis of the leukemia burden among Hispanic children.
  
  
  
  Leukemias diagnosed among non-Hispanic white (NHW), Hispanic, African American (AA), and Asian/Pacific Islander (API) children aged birth to 19 years between January 1, 1990 and December 31, 2012 were obtained from the California Cancer Registry (11,084 cases). Age-adjusted incidence rates, standardized rate ratios (SRRs), and secular trends in incidence (annual percent change [APC]) were analyzed by subtype, race/ethnicity, sex, and age.
  
  
  
  Compared with NHW children, the incidence of acute lymphoblastic leukemia (ALL) was higher among Hispanic (SRR, 1.32) and lower among AA (SRR, 0.55) and API (SRR, 0.91) children. From 1990 to 2012, the incidence of ALL increased overall (APC, 1.1%) and among males (APC, 1.0%), females (APC, 1.3%), Hispanics (APC, 1.1%), AAs (APC, 1.9%), AA males (APC, 2.8%), API males (APC, 1.9%), and Hispanic females (APC, 1.5%). The incidence of ALL increased among Hispanic males aged 15 to 19 years (APC, 2.5%) and Hispanic females aged birth to 4 years and 15 to 19 years (APCs of 2.2% and 1.9%, respectively). The incidence of acute myeloid leukemia did not appear to differ among racial/ethnic groups. From 1990 to 2012, the overall incidence of acute myeloid leukemia remained stable but increased among Hispanics (APC, 1.2%), females (APC, 1.0%), Hispanic females (APC, 2.3%), and Hispanic females aged 15 to 19 years (APC, 3.4%).
  
  
  
  Notable differences in the incidence of childhood leukemia were observed among 4 racial/ethnic groups in California. Factors that may contribute to these differences include differential exposure to carcinogens and/or genetic susceptibility. Cancer 2016. © 2016 American Cancer Society. Cancer 2016;122:2867-2875. © 2016 American Cancer Society.
authors.affiliation: California Cancer Reporting and Epidemiologic Surveillance Program, Institute for Population Health Improvement, UC Davis Health System, Sacramento, California.
authors.forename: Brenda M
authors.identifier: 0000-0001-7480-1642
authors.initials: BM
authors.lastname: Giddings
authors.affiliation: Department of Epidemiology, University of California at Berkeley School of Public Health, Berkeley, California.|Center for Integrative Research on Childhood Leukemia and the Environment, University of California at Berkeley, Berkeley, California.
authors.forename: Todd P
authors.initials: TP
authors.lastname: Whitehead
authors.affiliation: Center for Integrative Research on Childhood Leukemia and the Environment, University of California at Berkeley, Berkeley, California.|Department of Epidemiology and Biostatistics, University of California at Berkeley School of Public Health, Berkeley, California.
authors.forename: Catherine
authors.initials: C
authors.lastname: Metayer
authors.affiliation: Center for Integrative Research on Childhood Leukemia and the Environment, University of California at Berkeley, Berkeley, California.|Western States Pediatric Environmental Health Specialty Unit, University of California at San Francisco, San Francisco, California.
authors.forename: Mark D
authors.initials: MD
authors.lastname: Miller
mesh_terms: D000293:Adolescent; D000328:Adult; D002140:California / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000453:epidemiology* / Q000208:ethnology*; D055815:Young Adult
keywords: Hispanic; children; epidemiology; incidence; leukemia; trends