Childhood cancer incidence and survival in Japan and England: A population-based study (1993-2010)

Abstract

The present study aimed to compare cancer incidence and trends in survival for children diagnosed in Japan and England, using population-based cancer registry data. The analysis was based on 5192 children with cancer (age 0-14 years) from 6 prefectural cancer registries in Japan and 21 295 children diagnosed in England during 1993-2010. Differences in incidence rates between the 2 countries were measured with Poisson regression models. Overall survival was estimated using the Kaplan-Meier method. Incidence rates for Hodgkin lymphoma, renal tumors and Ewing sarcomas in England were more than twice as high as those in Japan. Incidence of germ cell tumors, hepatic tumors, neuroblastoma and acute myeloid leukemia (AML) was higher in Japan than in England. Incidence of all cancers combined decreased in Japan throughout the period 1993 to 2010, which was mainly explained by a decrease in registration of neuroblastoma in infants. For many cancers, 5-year survival improved in both countries. The improvement in survival in chronic myeloid leukemia (CML) was particularly dramatic in both countries. However, 5-year survival remained less than 80% in 2005-2008 in both countries for AML, brain tumors, soft tissue sarcomas, malignant bone tumors and neuroblastoma (age 1-14 years). There were significant differences in incidence of several cancers between countries, suggesting variation in genetic susceptibility and possibly environmental factors. The decrease in incidence for all cancers combined in Japan was related to the cessation of the national screening program for neuroblastoma. The large improvement in survival in CML coincided with the introduction of effective therapy (imatinib).

Keywords: cancer registry data; childhood cancer; childhood cancer incidence and survival; epidemiology; population-based study.

Figure 1

Age‐standardized incidence rate of childhood cancer (age 0‐14 y) by cancer type in Japan and England, 1993‐2010. The error bars indicate the 95% confidence intervals. ALL, acute lymphoblastic leukemias; AML, acute myeloid leukemias; CML, chronic myeloid leukemia; CNS, central nervous system; NBL, neuroblastoma

Figure 2

Five‐year survival for each cancer type in Japan and England, 1993‐1996 and 2005‐2008. Five‐year survival for some major diagnostic groups in Japan and England are plotted on the same graphic for each period. ALL, acute lymphoblastic leukemias; AML, acute myeloid leukemias; CML, chronic myeloid leukemia; CNS, central nervous system; NBL, neuroblastoma; RMS, rhabdomyosarcoma

Figure 3

Change in 5‐y survival for each cancer type from 1993‐1996 to 2005‐2008, in Japan and England. ALL, acute lymphoblastic leukemias; AML, acute myeloid leukemias; CML, chronic myeloid leukemia; CNS, central nervous system GCTs, germ cell tumors; NBL, neuroblastoma; RMS, rhabdomyosarcoma