Steliarova-Foucher E et al. (2004) Geographical patterns and time trends of cancer incidence and survival among children and adolescents in Europe since the 1970s (the ACCIS project): an epidemiological study. Lancet 364: 2097–2105
Because childhood cancers are relatively rare, analysis of trends in incidence depends on large-scale, long-term disease registries. Drawing on data collected over 30 years, Steliarova-Foucher and colleagues have recently reported on geographical and temporal patterns of cancer incidence in children and adolescents in Europe. The study shows that the overall incidence of cancer is increasing, and highlights disparities between developed and developing countries in the availability of specialized medical care.
The study included high-quality data on 113,000 tumors in children and 18,243 tumors in adolescents, from 63 population-based cancer registries in 19 European countries. In children under 15 years of age, the overall incidence of cancer rose by 1.0% per year between 1970–2001, reaching an age-standardized incidence rate of 140 per million in the 1990s (with leukemias, tumors of the central nervous system, and lymphomas being the most frequent). In adolescents, a 1.5% yearly increase in cancer incidence was recorded—with carcinomas, lymphomas and germ-cell tumors showing the sharpest rise—and the age-standardized incidence rate rose to 157 per million in the same period. Analysis of cancer cases by geographical region showed that overall 5-year survival was higher in the west (75%) than in the east (64%), probably reflecting differences in referral practice and access to costly treatment. Across Europe as a whole, however, survival rates had improved significantly since the 1970s.
The authors suggest that these findings could be used to evaluate changes in policy and clinical care, provided that the existing database is maintained.