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. 2022 Dec 27;20(1):443.
doi: 10.3390/ijerph20010443.

Looking Towards 2030: Strengthening the Environmental Health in Childhood-Adolescent Cancer Survivor Programs

Laura T Cabrera-Rivera  1   2   3 , Brittney Sweetser  1   3   4 , José L Fuster-Soler  1   5 , Rebeca Ramis  1   6 , Fernando A López-Hernández  1   7 , Antonio Pérez-Martínez  1   8 , Juan A Ortega-García  1   3   9
Affiliations

Looking Towards 2030: Strengthening the Environmental Health in Childhood-Adolescent Cancer Survivor Programs

Laura T Cabrera-Rivera et al. Int J Environ Res Public Health. .

Abstract

Childhood and adolescent cancer survivors (CACS) are a high-risk population for non-communicable diseases and secondary carcinogenesis. The Environmental and Community Health Program for Longitudinal Follow-up of CACS in the region of Murcia, Spain, is an ongoing pioneering program that constitutes a model for social innovation. This study aims to present the program tools and protocol as a whole, as well as a profile of the incidence, survival, and spatiotemporal distribution of childhood cancer in the region of Murcia, Spain, using 822 sample cases of cancer diagnosed in children under 15 years of age (1998-2020). While the crude incidence rate across that entire period was 149.6 per 1 million, there was an increase over that time in the incidence. The areas with a higher standardized incidence ratio have shifted from the northwest (1998-2003) to the southeast (2016-2020) region. Overall, the ten-year survival rate for all tumor types was 80.1% over the entire period, increasing the five-year survival rate from 76.1 (1998-2003) to 85.5 (2014-2018). CACS living in areas with very poor outdoor air quality had lower survival rates. Furthermore, integrating environmental health into clinical practice could improve knowledge of the etiology and prognosis, as well as the outcomes of CACS. Finally, monitoring individual carbon footprints and creating healthier lifestyles, alongside healthier environments for CACS, could promote wellbeing, environmental awareness, and empowerment in order to attain Sustainable Development Goals for non-communicable diseases in this population.

Keywords: carbon footprint; environmental health; pediatric cancer; spatiotemporal analysis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Total patients included in MACAPEMUR (1998–2020).
Figure 2
Figure 2
Cumulative survival per year of survival of the three groups of the Likert scale for air pollution in the region of Murcia (1998–2020).
Figure 3
Figure 3
Childhood cancer survival across different time periods 1998–2018 (n = 733). The Cox proportional hazards regression model demonstrates that the survival rate for all childhood cancers has improved over time [log rank = 0.206].
Figure 4
Figure 4
SIR by health areas and basic health zones in the region of Murcia, 1998–2020 (n = 822). Figure 4A presents the spatial distribution of the SIR for each of the 9 health areas in the region of Murcia. Figure 4B shows the spatial distribution of the SIR in the 90 basic health zones in the region of Murcia. The vector data correspond to the residential addresses of each case at the time of the cancer diagnosis. The maps are divided by the health areas and basic health zones that exist in 2021. SIR: standardized incidence ratio.
Figure 5
Figure 5
SIR by health areas and time cohort in the region of Murcia, 1998–2020 (n = 822).
See this image and copyright information in PMC

References

    1. Siegel R.L., Miller K.D., Fuchs H.E., Jemal A. Cancer Statistics, 2021. CA A Cancer J. Clin. 2021;71:7–33. doi: 10.3322/caac.21654. - DOI - PubMed
    1. Ortega-García J.A., López-Hernández F.A., Cárceles-Álvarez A., Santiago-Rodríguez E.J., Sánchez A.C., Bermúdez-Cortes M., Fuster-Soler J.L. Analysis of small areas of pediatric cancer in the municipality of Murcia (Spain) An. Pediatr. (Barc.) 2016;84:154–162. doi: 10.1016/j.anpedi.2015.04.021. - DOI - PubMed
    1. Stiller C.A., Marcos-Gragera R., Ardanaz E., Pannelli F., Almar Marqués E., Cañada Martinez A., Steliarova-Foucher E. Geographical Patterns of Childhood Cancer Incidence in Europe, 1988–1997. Report from the Automated Childhood Cancer Information System Project. Eur. J. Cancer. 2006;42:1952–1960. doi: 10.1016/j.ejca.2006.05.017. - DOI - PubMed
    1. REDECAN Working Group. Galceran J., Ameijide A., Carulla M., Mateos A., Quirós J.R., Rojas D., Alemán A., Torrella A., Chico M., et al. Cancer Incidence in Spain, 2015. Clin. Transl. Oncol. 2017;19:799–825. doi: 10.1007/s12094-016-1607-9. - DOI - PubMed
    1. Magrath I., Steliarova-Foucher E., Epelman S., Ribeiro R.C., Harif M., Li C.-K., Kebudi R., Macfarlane S.D., Howard S.C. Paediatric Cancer in Low-Income and Middle-Income Countries. Lancet Oncol. 2013;14:e104–e116. doi: 10.1016/S1470-2045(13)70008-1. - DOI - PubMed

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