International incidence of childhood cancer, 2001-10: a population-based registry study

Abstract

Background: Cancer is a major cause of death in children worldwide, and the recorded incidence tends to increase with time. Internationally comparable data on childhood cancer incidence in the past two decades are scarce. This study aimed to provide internationally comparable local data on the incidence of childhood cancer to promote research of causes and implementation of childhood cancer control.

Methods: This population-based registry study, devised by the International Agency for Research on Cancer in collaboration with the International Association of Cancer Registries, collected data on all malignancies and non-malignant neoplasms of the CNS diagnosed before age 20 years in populations covered by high-quality cancer registries with complete data for 2001-10. Incidence rates per million person-years for the 0-14 years and 0-19 years age groups were age-adjusted using the world standard population to provide age-standardised incidence rates (WSRs), using the age-specific incidence rates (ASR) for individual age groups (0-4 years, 5-9 years, 10-14 years, and 15-19 years). All rates were reported for 19 geographical areas or ethnicities by sex, age group, and cancer type. The regional WSRs for children aged 0-14 years were compared with comparable data obtained in the 1980s.

Findings: Of 532 invited cancer registries, 153 registries from 62 countries, departments, and territories met quality standards, and contributed data for the entire decade of 2001-10. 385 509 incident cases in children aged 0-19 years occurring in 2·64 billion person-years were included. The overall WSR was 140·6 per million person-years in children aged 0-14 years (based on 284 649 cases), and the most common cancers were leukaemia (WSR 46·4), followed by CNS tumours (WSR 28·2), and lymphomas (WSR 15·2). In children aged 15-19 years (based on 100 860 cases), the ASR was 185·3 per million person-years, the most common being lymphomas (ASR 41·8) and the group of epithelial tumours and melanoma (ASR 39·5). Incidence varied considerably between and within the described regions, and by cancer type, sex, age, and racial and ethnic group. Since the 1980s, the global WSR of registered cancers in children aged 0-14 years has increased from 124·0 (95% CI 123·3-124·7) to 140·6 (140·1-141·1) per million person-years.

Interpretation: This unique global source of childhood cancer incidence will be used for aetiological research and to inform public health policy, potentially contributing towards attaining several targets of the Sustainable Development Goals. The observed geographical, racial and ethnic, age, sex, and temporal variations require constant monitoring and research.

Funding: International Agency for Research on Cancer and the Union for International Cancer Control.

Figure 1

Variation in the overall incidence of childhood cancer by geographical region, 2001–10 Data are for children aged 0–14 years, from the paediatric dataset (A), and 15–19 years, from the general dataset (B). We only included registries with more than 100 cases when assessing the lowest and highest rates. ASR=age-specific rate. WSR=age-standardised rate (world standard population). *Comprising data from India only.

Figure 2

Proportional distribution of cancer type by age group, 2001–10, all regions combined Tumours classified by International Classification of Childhood Cancer, volume 3. Statistics for children younger than 15 years are based on the paediatric dataset and the statistics for those aged 15–19 years are based on the general dataset.

Figure 3

Incidence of cancer in children aged 0–14 years, 2001–10, by region Incidence of all tumours (A) and less common cancers (B). Tumours classified by International Classification of Childhood Cancer, volume 3. Data are based on the paediatric dataset. WSR=age-standardised rate (world standard population). *Comprising data from India only. †Defined in (B).

Figure 4

Incidence of cancer in young people aged 15–19 years, 2001–10, by region Tumours classified by International Classification of Childhood Cancer, volume 3. Data are based on the general dataset. ASR=age-specific rate. *Comprising data from India only.

Figure 5

Comparison of incidence of neoplasms in children aged 0–14 years in 1980–89 and 2001–10, by region Data from the two time periods were standardised and peer reviewed using similar methods. Error bars show 95% CI. IICC-2=International Incidence of Childhood Cancer, volume 2. IICC-3=paediatric dataset (defined in table 2 and appendix pp 3–4). WSR=age-standardised rate (world standard population). *Comprising data from India only.