title: Incidence and survival time trends for Spanish children and adolescents with leukaemia from 1983 to 2007.
abstract: OBJECTIVE
  We have analysed incidence and survival trends of children and adolescents with leukaemia registered in Spanish population-based cancer registries during the period 1983-2007.
  
  
  METHODS
  Childhood and adolescent leukaemia cases were drawn from the 11 Spanish population-based cancer registries. For survival, registries with data for the period 1991-2005 and follow-up until 31-12-2010 were included. Overall incidence trends were evaluated using joinpoint analysis. Observed survival rates were estimated using Kaplan-Meier, and trends were tested using the log-rank test.
  
  
  RESULTS
  Based on 2606 cases (2274 children and 332 adolescents), the overall age-adjusted incidence rate (ASRw) of leukaemia was 47.9 cases per million child-years in children and 23.8 in adolescents. The ASRw of leukaemia increased with an annual percentage change of 9.6 % (95 % CI: 2.2-17.6) until 1990 followed by a stabilisation of rates. In adolescents, incidence did not increase. Five-year survival increased from 66 % in 1991-1995 to 76 % in 2001-2005. By age, survival was dramatically lower in infants (0) and adolescents (15-19) than in the other age groups and no improvement was observed. In both children and adolescents, differences in 5-year survival rates among major subgroups of leukaemias were significant.
  
  
  CONCLUSIONS
  The increasing incidence trends observed in childhood leukaemias during the study period were confined to the beginning of the period. Remarkable improvements in survival have been observed in Spanish children with leukaemias. However, this improvement was not observed in infants and adolescents.
authors.affiliation: Epidemiology Unit and Girona Cancer Registry (UERCG), Oncology Coordination Plan (PDO), Department of Health, Autonomous Government of Catalonia, Girona, Spain. rmarcos@iconcologia.net.|Descriptive Epidemiology, Genetics and Cancer Prevention Group [Girona Biomedical Research Institute] IDIBGI, Catalan Institute of Oncology-Girona (ICO), Girona, Spain. rmarcos@iconcologia.net.|Nursing Department, University of Girona (UdG), Girona, Spain. rmarcos@iconcologia.net.
authors.forename: R
authors.identifier: http://orcid.org/0000-0001-9824-3657
authors.initials: R
authors.lastname: Marcos-Gragera
authors.affiliation: Tarragona Cancer Registry, Foundation Society for Cancer Research and Prevention (FUNCA), Reus, Spain.|Pere Virgili Health Research Institute, Reus, Spain.|Rovira i Virgili University (URV), Reus, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Galceran
authors.affiliation: Zaragoza Cancer Registry, Aragon Government, Saragossa, Spain.|Centre of Public Health Research-FISABIO, Valencia, Spain.|Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública CIBERESP), Madrid, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Martos
authors.affiliation: Basque Country Cancer Registry, Basque Government, Vitoria-Gasteiz, Spain.
authors.forename: A L
authors.initials: AL
authors.lastname: de Munain
authors.affiliation: Community Valenciana Childhood Cancer Registry, Public Health Directorate, Conselleria de Sanitat Universal i Salut Pública, Generalitat Valenciana, Valencia, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Vicente-Raneda
authors.affiliation: Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain.|Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain.|Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública CIBERESP), Madrid, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Navarro
authors.affiliation: Public Health Directorate, Asturias, Spain.
authors.forename: J R
authors.initials: JR
authors.lastname: Quirós-Garcia
authors.affiliation: Granada Cancer Registry, Andalusian School of Public Health, Granada, Spain.|Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública CIBERESP), Madrid, Spain.
authors.forename: M-J
authors.initials: MJ
authors.lastname: Sánchez
authors.affiliation: Navarre Cancer Registry, Navarre Public Health Institute, Pamplona, Spain.|IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.|Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública CIBERESP), Madrid, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Ardanaz
authors.affiliation: Mallorca Cancer Registry, Epidemiology Department, Directorate-General of Public Health and Participation, Palma de Mallorca, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Ramos
authors.affiliation: Albacete Cancer Registry, Health and Social Welfare Authority, Albacete, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Mateos
authors.affiliation: Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain.|Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain.|Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública CIBERESP), Madrid, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Salmerón
authors.affiliation: Spanish Childhood Cancer Registry (RETI-SEHOP), Spanish Society of Paediatric Haematology and Oncology, University of Valencia, Valencia, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Felipe
authors.affiliation: Spanish Childhood Cancer Registry (RETI-SEHOP), Spanish Society of Paediatric Haematology and Oncology, University of Valencia, Valencia, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Peris-Bonet
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007938:Leukemia / Q000453:epidemiology* / Q000401:mortality*; D008297:Male; D009367:Neoplasm Staging; D011379:Prognosis; D012042:Registries / Q000706:statistics & numerical data*; D013030:Spain / Q000453:epidemiology; D015996:Survival Rate; D013997:Time Factors; D055815:Young Adult
keywords: Adolescent leukaemia; Cancer registry; Cancer survival; Childhood cancer; Childhood leukaemia; Global health