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Childhood Cancer Up in Europe Since the 1970s

Cases Are Still Rare Under Age 20, and Survival Has Increased Substantially
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WebMD Health News

Dec. 9, 2004 -- Cancer now affects more European children and teens than 30 years ago, new research shows. Thankfully, it's still rare among people younger than 20, and European survival rates have improved with every decade.

The findings come from experts including Eva Steliarova-Foucher, PhD, of the International Agency for Research in Cancer based in Lyon, France. The study appears in the Dec. 11 issue of The Lancet.

High-quality data came from 63 European cancer registries in 19 countries. Eastern nations such as Belarus and Estonia were included, along with western countries, such as Italy, France, and the U.K.

Since the 1970s, overall European cancer incidence has increased by 1% annually for children and 1.5% among adolescents, say the researchers. They don't know why. "No single factor can be held responsible," they say.

In the 1990s, cancer affected 140 children per million European children and 157 children per million adolescents. Eastern countries had slightly higher rates for children and lower rates for teens.

Europe's childhood cancer numbers have risen at least 1% annually for the last 30 years. Between the 1980s and 1990s, the rate accelerated slightly, edging up 1.3% per year.

The same trend was true for teens. Cancer struck 147 per million adolescents in the 1970s, 165 per million in the 1980s, and 193 per million in the 1990s.

Most tumor types of cancer increased among children. For adolescents, lymphomas, carcinomas, and germ-cell tumors stood out with notable increases.

Overall, boys had more cases of cancer than girls. The few exceptions were germ-cell tumors in specific age groups and thyroid carcinomas.

Cancer Survival Better Than Ever

More European children survive cancer than in the past.

Thirty years ago, 44% of European children with cancer survived for five years. For those diagnosed in the 1980s, the overall five-year survival rate was 64%. In the 1990s, it reached 74% for newly diagnosed children. Adolescents had similar five-year survival figures.

Survival rates were better in western countries. That could be due to earlier diagnosis, better referral, or greater availability of complex, expensive treatments, say the researchers.

Accuracy is also vital.

"Both underdiagnosis and underregistration will lead to low estimates, and as these factors improve we are given the impression of cancer incidence rising over time," says Catherine Cole of Australia's Princess Margaret Hospital. "Only time and further collection of data will solve this dilemma.

Childhood cancer is most common and deadliest in developing countries, says Cole, commenting in The Lancet.

"Despite 80% survival rates in the West, most children with cancer in developing countries will die due to lack of medical care," she writes. "The challenge now is to ensure equity of access to cancer care for all children."

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