Cancer incidence and survival in European adolescents (1978–1997). Report from the Automated Childhood Cancer Information System project
Introduction
The international variations in the incidence of cancer in children are relatively well documented.1 There has also been detailed exploration of survival rates among children in Europe.2, 3, 4 There is considerably less published information on cancer incidence and survival among European adolescents.5, 6
In Europe, less than 0.3% of all cancer cases occur in adolescents aged 15–19 years.7 The pattern of tumour types occurring most commonly in this age group is distinctive, including some typical childhood tumours and others that occur mostly in adults. The most frequent tumour types are lymphomas, carcinomas, germ cell tumours, leukaemias, sarcomas and central nervous system (CNS) tumours.5
The Automated Childhood Cancer Information System (ACCIS) is a collaborative project of the European cancer registries, aiming at collection, presentation and interpretation of data on cancer incidence and adolescents in Europe.5 In this paper we use the ACCIS database to present an overview of geographical patterns and time trends in the incidence and survival rates for cancer among European adolescents.
Section snippets
Material and methods
Detailed information on the ACCIS database is given elsewhere [Steliarova-Foucher, Kaatsch, Lacour and colleagues, this issue]. For this study, the analyses were based on data from the 49 population-based cancer registries in 16 countries, listed in Table 1, which met defined quality criteria for completeness, validity and comparability. All registrations for malignant neoplasms, together with non-malignant CNS tumours, registered during 1978–1997 in adolescents aged 15–19 years in the
Results
Table 3 presents incidence rates in Europe and the five European regions for each diagnostic group within the ICCC. Total incidence varied widely, from 169 per million in the East to 210 per million in the North. Lymphomas were the most frequent diagnostic group overall and in each region, accounting for around a quarter of all cancers. Epithelial tumours (carcinomas of sites other than kidney, liver and gonadal, together with melanoma) everywhere constituted the second most common group. The
Discussion
Cancer incidence among adolescents is more than 50% higher than at age 10–14 years, marking the start of the inexorable rise in incidence through adulthood. There was a distinctive distribution of diagnostic groups, with the most frequent being, in descending order, lymphomas, epithelial tumours, germ cell and gonadal tumours, CNS tumours and leukaemia (Fig. 2). This contrasts with the pattern in childhood, when the most frequent diagnostic group is leukaemia, followed by CNS tumours, lymphomas
Conflict of interest statement
None declared.
Acknowledgements
The ACCIS project was funded by the European Commission from the ’Europe Against Cancer’ action programme, (1996–2002, contracts SI2.126875, SI2.321970 and SPC.2002303), jointly with the International Agency for Research on Cancer. Data analyses were partly funded by the French Ligue Nationale contre le Cancer, Comité du Rhône. The Childhood Cancer Research Group receives funding from the Department of Health and the Scottish Ministers. The views expressed in the publication are those of the
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