Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Updated retinoblastoma incidence and outcome in children in Taiwan from 1980 to 2019: a 40-year nationwide study

Eye (2024)Cite this article

Subjects

Abstract

Background

Retinoblastoma is a potentially fatal disease, and its incidence and mortality varies among different countries and periods.

Methods

This is a nationwide population-based retrospective study from January 1980 to December 2019 in Taiwan. Patients diagnosed as retinoblastoma were identified from the Taiwan National Cancer Registry. To update the literature on retinoblastoma incidence, mortality and trends in Taiwan, we analysed changes in incidence and survival rates over time according to sex, diagnostic age, laterality and treatment.

Results

During 1980–2019, the incidence of retinoblastoma in Taiwan was 1 per 16 489 live births (95% CI: 13 415–19 564). The diagnostic age decreased from 2.21 ± 0.26 during 1980–1984 to 1.24 ± 0.26 during 1985–2019. Compared with that observed during 1980–1989, the incidence rate observed after 1990 increased significantly in children aged <10 years (RR: 1.62–2.40, P = 0.0049 to < 0.0001). From 1980 to 2019, the incidence rate for the 0–4-year age group increased and that for the 5–9-year age group remained constant. The mean diagnostic age for bilateral retinoblastoma (0.36 ± 0.47 years) was significantly less than that for unilateral retinoblastoma (1.37 ± 0.35 years) during 2007–2019 (P < 0.0001). The 10-year survival rate was highest in the enucleation group (89.8%) compared with radiotherapy (52.2%) and others (70.0%; P < 0.0001).

Conclusions

During 1980–2019 in Taiwan, the incidence of retinoblastoma increased significantly, and the diagnostic age decreased, which are similar to the ones from other developed countries. However, the survival rate was still lower than that of most developed countries.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Age-standardised incidence rates of retinoblastoma in Taiwan during 1980–2019.
Fig. 2: Mean diagnostic age of retinoblastoma in Taiwan during 1980–2019.
Fig. 3: The 10-year overall survival rates of retinoblastoma patients in Taiwan treated with different modalities.

Similar content being viewed by others

Data availability

The data that support the findings of this study are available from the corresponding author, CYT, upon reasonable request.

References

  1. Kivela T. The epidemiological challenge of the most frequent eye cancer: retinoblastoma, an issue of birth and death. Br J Ophthalmol. 2009;93:1129–31.

    Article  PubMed  Google Scholar 

  2. Dimaras H, Corson TW, Cobrinik D, White A, Zhao J, Munier FL, et al. Retinoblastoma. Nat Rev Dis Prim. 2015;1:15021.

    Article  PubMed  Google Scholar 

  3. Dimaras H, Kimani K, Dimba EAO, Gronsdahl P, White A, Chan HSL, et al. Retinoblastoma. Lancet. 2012;379:1436–46.

    Article  PubMed  Google Scholar 

  4. Global Retinoblastoma Study G, Fabian ID, Abdallah E, Abdullahi SU, Abdulqader RA, Adamou Boubacar S, et al. Global retinoblastoma presentation and analysis by national income level. JAMA Oncol. 2020;6:685–95.

    Article  Google Scholar 

  5. Shields CL, Fulco EM, Arias JD, Alarcon C, Pellegrini M, Rishi P, et al. Retinoblastoma frontiers with intravenous, intra-arterial, periocular, and intravitreal chemotherapy. Eye. 2013;27:253–64.

    Article  CAS  PubMed  Google Scholar 

  6. Ancona-Lezama D, Dalvin LA, Shields CL. Modern treatment of retinoblastoma: A 2020 review. Indian J Ophthalmol. 2020;68:2356–65.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Tomar AS, Finger PT, Gallie B, Mallipatna A, Kivela TT, Zhang C, et al. A Multicenter, International Collaborative Study for American Joint Committee on Cancer Staging of Retinoblastoma: Part I: metastasis-associated mortality. Ophthalmology. 2020;127:1719–32.

    Article  PubMed  Google Scholar 

  8. Tomar AS, Finger PT, Gallie B, Mallipatna A, Kivela TT, Zhang C, et al. A Multicenter, International Collaborative Study for American Joint Committee on Cancer Staging of Retinoblastoma: Part II: treatment success and globe salvage. Ophthalmology. 2020;127:1733–46.

    Article  PubMed  Google Scholar 

  9. Fernandes AG, Pollock BD, Rabito FA. Retinoblastoma in the United States: a 40-year incidence and survival analysis. J Pediatr Ophthalmol Strabismus. 2018;55:182–8.

    Article  PubMed  Google Scholar 

  10. Knudson AG Jr. Mutation and cancer: statistical study of retinoblastoma. Proc Natl Acad Sci USA. 1971;68:820–3.

    Article  ADS  PubMed  PubMed Central  Google Scholar 

  11. Karaoui MS. Retinoblastoma: a new challenge to the Knudson’s Dogma. Saudi J Ophthalmol. 2013;27:133–4.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Rushlow DE, Mol BM, Kennett JY, Yee S, Pajovic S, Thériault BL, et al. Characterisation of retinoblastomas without RB1 mutations: genomic, gene expression, and clinical studies. Lancet Oncol. 2013;14:327–34.

    Article  CAS  PubMed  Google Scholar 

  13. Committee for the National Registry of R. The National Registry of Retinoblastoma in Japan (1983-2014). Jpn J Ophthalmol. 2018;62:409–23.

    Article  Google Scholar 

  14. Wong JR, Tucker MA, Kleinerman RA, Devesa SS. Retinoblastoma incidence patterns in the US surveillance, epidemiology, and end results program. JAMA Ophthalmol. 2014;132:478–83.

    Article  PubMed  Google Scholar 

  15. Lim FP, Soh SY, Iyer JV, Tan AM, Swati H, Quah BL. Clinical profile, management, and outcome of retinoblastoma in singapore. J Pediatr Ophthalmol Strabismus. 2013;50:106–12.

    Article  PubMed  Google Scholar 

  16. Nowak MS, Romanowska-Dixon B, Grabska-Liberek I, Zurek M. Incidence and characteristics of retinoblastoma in Poland: the first nationwide Study 2010-2017. Int J Environ Res Public Health. 2021;18:6539.

  17. Darwich R, Ghazawi FM, Rahme E, Alghazawi N, Burnier JV, Sasseville D, et al. Retinoblastoma incidence trends in Canada: a national comprehensive population-based study. J Pediatr Ophthalmol Strabismus. 2019;56:124–30.

    Article  PubMed  Google Scholar 

  18. Li SY, Chen SC, Tsai CF, Sheu SM, Yeh JJ, Tsai CB. Incidence and survival of retinoblastoma in Taiwan: a nationwide population-based study 1998-2011. Br J Ophthalmol. 2016;100:839–42.

    Article  PubMed  Google Scholar 

  19. Tomar AS, Finger PT, Gallie B, Kivela TT, Mallipatna A, Zhang C, et al. Global retinoblastoma treatment outcomes: association with national income level. Ophthalmology. 2021;128:740–53.

    Article  PubMed  Google Scholar 

  20. Kaliki S, Patel A, Iram S, Ramappa G, Mohamed A, Palkonda VAR. RETINOBLASTOMA IN INDIA: clinical presentation and outcome in 1,457 patients (2,074 Eyes). Retina. 2019;39:379–91.

    Article  PubMed  Google Scholar 

  21. Goolam S, Kana H, Welsh N, Wainwright L, Poole J, Mayet I. A 20-year retrospective review of retinoblastoma at two tertiary academic hospitals in Johannesburg, South Africa. Ocul Oncol Pathol. 2018;4:170–5.

    Article  PubMed  Google Scholar 

  22. Gichigo EN, Kariuki-Wanyoike MM, Kimani K, Nentwich MM. Retinoblastoma in Kenya: survival and prognostic factors. Ophthalmologe. 2015;112:255–60.

    Article  CAS  PubMed  Google Scholar 

  23. Park SJ, Woo SJ, Park KH. Incidence of retinoblastoma and survival rate of retinoblastoma patients in Korea using the Korean National Cancer Registry database (1993-2010). Invest Ophthalmol Vis Sci. 2014;55:2816–21.

    Article  PubMed  Google Scholar 

  24. Ueda T, Koga Y, Yoshikawa H, Tanabe M, Yamana K, Oba U, et al. Survival and ocular preservation in a long-term cohort of Japanese patients with retinoblastoma. BMC Pediatr. 2020;20:37.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Desandes E, Faure L, Guissou S, Goujon S, Berger C, Minard-Colin V, et al. Infant cancers in France: Incidence and survival (2000-2014). Cancer Epidemiol. 2020;65:101697.

    Article  PubMed  Google Scholar 

  26. MacCarthy A, Birch JM, Draper GJ, Hungerford JL, Kingston JE, Kroll ME, et al. Retinoblastoma in Great Britain 1963-2002. Br J Ophthalmol. 2009;93:33–7.

    Article  CAS  PubMed  Google Scholar 

  27. Broaddus E, Topham A, Singh AD. Survival with retinoblastoma in the USA: 1975-2004. Br J Ophthalmol. 2009;93:24–7.

    Article  CAS  PubMed  Google Scholar 

  28. Chen YH, Lin HY, Hsu WM, Lee SM, Cheng CY. Retinoblastoma in Taiwan: incidence and survival characteristics from 1979 to 2003. Eye. 2010;24:318–22.

    Article  PubMed  Google Scholar 

  29. Kao LY, Su WW, Lin YW. Retinoblastoma in Taiwan: survival and clinical characteristics 1978-2000. Jpn J Ophthalmol. 2002;46:577–80.

    Article  PubMed  Google Scholar 

  30. Chen PY, Kao LY, Chao AN, Wu WC, Sun MH, Su WW, et al. Retinoblastoma in Taiwan: survival and clinical characteristics. Jpn J Ophthalmol. 2021;65:546–53.

    Article  PubMed  Google Scholar 

  31. Chang CY, Chiou TJ, Hwang B, Bai LY, Hsu WM, Hsieh YL. Retinoblastoma in Taiwan: survival rate and prognostic factors. Jpn J Ophthalmol. 2006;50:242–9.

    Article  PubMed  Google Scholar 

  32. Chiang CJ, You SL, Chen CJ, Yang YW, Lo WC, Lai MS. Quality assessment and improvement of nationwide cancer registration system in Taiwan: a review. Jpn J Clin Oncol. 2015;45:291–6.

    Article  PubMed  Google Scholar 

  33. Chiang CJ, You SL, Chen CJ, Yang YW, Lo WC, Lai MS. Quality assessment and improvement of nationwide cancer registration system in Taiwan: a review. Jpn J Clin Oncol. 2015;45:291–6.

  34. Nummi K, Kivela TT. Retinoblastoma in Finland, 1964-2014: incidence and survival. Br J Ophthalmol. 2021;105:63–9.

    Article  PubMed  Google Scholar 

  35. Moll AC, Kuik DJ, Bouter LM, Den Otter W, Bezemer PD, Koten JW, et al. Incidence and survival of retinoblastoma in The Netherlands: a register based study 1862-1995. Br J Ophthalmol. 1997;81:559–62.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Broaddus E, Topham A, Singh AD. Incidence of retinoblastoma in the USA: 1975-2004. Br J Ophthalmol. 2009;93:21–3.

    Article  CAS  PubMed  Google Scholar 

  37. Stacey AW, Bowman R, Foster A, Kivela TT, Munier FL, Cassoux N, et al. Incidence of Retinoblastoma Has Increased: results from 40 European countries. Ophthalmology. 2021;128:1369–71.

    Article  PubMed  Google Scholar 

  38. [National registry of retinoblastoma in Japan (1975-1982). The Committee for the National Registry of Retinoblastoma]. Nippon Ganka Gakkai Zasshi 1992;96:1433–42.

  39. Su WW, Kao LY. Retinoblastoma in Taiwan: the effect of a government-sponsored national health insurance program on the treatment and survival of patients with retinoblastoma. J Pediatr Ophthalmol Strabismus. 2006;43:358–62.

    Article  PubMed  Google Scholar 

  40. Cassetti V, Sanders T, Bruce A. Challenges of Eye Health Care in Children and Strategies to Improve Treatment Uptake: A Qualitative Study from the Perspective of Eye Care Professionals in the UK. Br Ir Orthopt J. 2019;15:96–104.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Frazier M, De La Cruz N, Garcés IC. Development of educational materials to improve rates of early eye care for Hispanic children. J Immigr Minor Health. 2012;14:608–16.

    Article  PubMed  Google Scholar 

  42. Wakefield MA, Loken B, Hornik RC. Use of mass media campaigns to change health behaviour. Lancet. 2010;376:1261–71.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Saw SM, Tan N, Lee SB, Au Eong KG, Chia KS. Incidence and survival characteristics of retinoblastoma in Singapore from 1968-1995. J Pediatr Ophthalmol Strabismus. 2000;37:87–93.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors thank the Data Science Center, School of Medicine, Fu Jen Catholic University. for the assistance in data analysis. This study is supported by the Ministry of Science and Technology (MOST) of Republic of China (Taiwan) (No. 111-2221-E-030-015).

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Shin Kong Wu Ho Su Memorial Hospital, Taipei, Taiwan

    En-Tai Liao

  2. School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan

    En-Tai Liao, Hui-Yun Lin & Chia-Ying Tsai

  3. Department of Ophthalmology, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan

    Chia-Ying Tsai

Authors
  1. En-Tai Liao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hui-Yun Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chia-Ying Tsai
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

ETL was responsible for data curation, data analysis, original draft, manuscript review and editing. HYL was responsible for data analysis, manuscript review and editing. CYT was responsible for study design, data analysis, data interpretation, manuscript review and editing, supervision and funding acquisition.

Corresponding author

Correspondence to Chia-Ying Tsai.

Ethics declarations

Ethics approval

The study was approved by the Fu Jen Catholic University Hospital Institutional Review Board (FJUH-111186).

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Liao, ET., Lin, HY. & Tsai, CY. Updated retinoblastoma incidence and outcome in children in Taiwan from 1980 to 2019: a 40-year nationwide study. Eye (2024). https://doi.org/10.1038/s41433-024-02946-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1038/s41433-024-02946-0

Search

Advanced search

Quick links