The incidence of leukemia ranks first, and the latest data on childhood cancer in my country is disclosed…

Leukemia has the highest overall incidence of all cancers in children and adolescents at 39.34 per million people.

Writing |Ling Jun

Source | “Medical Community” Public Account

On September 24, 2022, a study published online in The Lancet reveals cancer prevalence in Chinese children (0-14 years) and adolescents (15-19 years) .

Research shows that between January 2018 and December 2020, approximately 121,145 children and adolescents in China were diagnosed with cancer. Leukemia is the most common cancer, accounting for nearly 30% of all diagnosed cases in children aged 1-4. The most common cancers in adolescents are malignant epithelial tumors and melanoma.

Data suggest that the burden of cancer in children and adolescents in China has increased compared to 2000-2015. In addition, the reported incidence of cancer also generally increased with the HDI (Human Development Index).

The study was completed by the team of Professor Ni Xin from Beijing Children’s Hospital Affiliated to Capital Medical University. The data came from the National Children’s Cancer Surveillance Center, the National Hospital Quality Monitoring System and public databases, covering 31 sites in mainland China. provinces, autonomous regions and municipalities directly under the Central Government.

From 2018 to the end of 2020, the age-standardized incidence of cancer among children and adolescents in China was 126.48/million people, with the highest incidence of cancer in children under 5 years old, and the highest incidence in children aged 5-9 years old. Incidence is the lowest and then gradually increases with age. Of all cancers, leukemia had the highest overall incidence at 39.34 per million people.

Childhood and adolescent cancer rates by age and sex

In children (0-14 years old), the incidence of leukemia was 43.33/million people, central nervous system tumors (19.59/million people), lymphoma (11.54/million people) ) ranked second and third in the incidence of childhood cancer.

Among them, common central nervous system tumors in children include astrocytoma (5.25/million people), intracranial and intraspinal embryonal tumors (3.99/million people). Neuroblastoma and ganglioneuroblastoma were the most common cancers in children under 1 year of age, accounting for 15.84% and 14.35% of all cases in boys and girls, respectively.

It is worth noting that this study found that leukemia accounts for about 32% of childhood cancers, lymphoma accounts for about 9.7%, and the remaining nearly 60% are solid tumors, indicating that the previous solid tumors in children The epidemiological burden is underestimated.

Leukemia incidence by age and sex in children and adolescents

Among adolescents (15-19 years old), malignant epithelial cancers and melanomas ranked first (30.39/million people), including thyroid cancer (18.12/million people), nasopharyngeal cancer (2.69/million people), colorectal cancer (2.1/million people). Among them, thyroid cancer had the highest incidence among girls aged 15-19, at 29.56/million people.

Leukemia (30.08 per million people) and tumors of the central nervous system (16.75 per million people) are the second and third most common cancers among adolescents, respectively.

Top 10 most common cancers in children and adolescents by age and sex

The more developed the economy, the higher the incidence of cancer?

The study also found that, despite differences across age groups, cancer incidence overall increased with HDI, the level of socioeconomic development, and in areas with the highest HDI, total cancer incidence The rate is 1.39 times that of the lowest HDI region.

HDI is arranged from low to high, corresponding to the approximate provinces/municipalities

But the data also suggest that trends are more pronounced among children. This may be closely related to the accessibility distribution of medical resources. Including pediatric cancer diagnosis and treatment institutions, pediatric beds, number of doctors, etc., this study also reported for the first time the accessibility of cancer diagnosis and health services in China.

For example, in very low HDI areas, there are only 0.04 cancer clinics, 11.84 pediatric beds, 0.76 pediatricians, and 0.48 pathology professionals per 1,000 square kilometers. The highest HDI regions were 3.23, 306.66, 86.4 and 88.82.

Density of clinics, paediatric beds, paediatricians, and pathologists by HDI region

This resulted in significant cross-regional visits. Among all new cases of childhood and adolescent cancers, 22.16% were diagnosed across regions. In regions with the lowest HDIs, more than a third of cancers were diagnosed outside the province. Specific to cancer, the highest proportion of cross-provincial diagnoses is retinoblastoma (56.56%).

Researchers believe that unequal access to medical services, including increased non-medical costs and the inconvenience of long-distance travel for children, is a barrier to early cancer diagnosis, leading to reported children in underdeveloped areas Cancer incidence is lower than in developed regions.

Unlike children, however, the incidence of most cancers in adolescents tends to decline as health care capacity improves. The researchers analyzed that this may be because in developed regions, some cancers can be diagnosed in early childhood, and emphasize the importance of early detection of cancer.

Trends in childhood and adolescent cancer incidence and access to care

Based on the above results, the researchers recommend:

In the later stages of the pandemic, departments need to increase resource allocation to improve the number of medical facilities and paediatric oncology professionals in less developed areas.

Integration among primary care facilities, maternal and child health hospitals, regional child health centers, and national child health centers should be strengthened, especially in areas with low access to health services.

As one of the effective measures to narrow the gap in medical access between regions, Internet medical services and artificial intelligence medical care should be continuously strengthened.

Targeted early cancer diagnosis programs are necessary, such as through eye screening and vision assessment in children aged 0-6 nationwide, and early diagnosis of retinoblastoma.

Source: Medicine

Proofreading: Zang Hengjia

Editor in charge: Tian Dongliang

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