Childhood cancer: Estimating regional and global incidence

Tom Johnston; Friederike Erdmann; Robert Newton; Eva Steliarova-Foucher; Joachim Schüz; Eve Roman

doi:10.1016/j.canep.2019.101662

Childhood cancer: Estimating regional and global incidence

Tom Johnston, Friederike Erdmann, Robert Newton, Eva Steliarova-Foucher, Joachim Schüz, Eve Roman

Health Sciences

Research output: Contribution to journal › Article › peer-review

Abstract

Most of the world’s population is not covered by cancer surveillance systems or vital registration, and worldwide/UN-regional cancer incidence is estimated using a variety of methods. Quantifying the cancer burden in children (<15 years) is more challenging than in adults; childhood cancer is rare and often presents with non-specific symptoms that mimic those of more prevalent infectious and nutritional conditions.MethodsA Baseline Model (BM) was constructed comprising a set of quality assured sex- and age-specific cancer rates derived from the US Surveillance, Epidemiology and End Results (SEER) program, for diagnostic groups of the International Classification of Childhood Cancers (ICCC-3) 3rd edition, and information on a known risk factor for endemic Burkitt lymphoma and Kaposi’s sarcoma. These rates were applied to global country-level population data for 2015 to estimate the global and regional incidence of childhood cancer. Results were compared to GLOBOCAN 2018, extrapolations from the International Incidence of Childhood Cancer (IICC-3) and estimates from the Global Childhood Cancer (GCC) model (based on IICC-3 data combined with information on health care systems and other parameters).ResultsThe BM estimated 360,114 total childhood cancers occurring worldwide in 2015; 54% in Asia and 28% in Africa. BM estimated standardised rates ranged from ∼178 cases per million in Europe and North America, through to ∼218 cases per million in West and Middle Africa. Totals from GLOBOCAN and extrapolations from the IICC-3 study were lower (44.6% and 34.7% respectively), but the estimate from the GCC model was 10.2% higher. In all models, agreement was good in countries with very high human development index (HDI), but more variable in countries with medium and low HDIs; the discrepancies correlating with registration coverage across these settings.ConclusionDisagreements between the BM estimates and other sources occur in areas where health systems are insufficiently equipped to provide adequate access to diagnosis, treatment, and supportive care. Incorporating aetiological evidence into the BM enabled the estimation of the additional burden of Burkitt lymphoma and Kaposi sarcoma; similar adjustments could be applied to other cancers, as and when information becomes available.AbbreviationsSEERSurveillance, Epidemiology and End Results programIICC-3International incidence of childhood cancer study, 3rd volumeICCC-3International classification of childhood cancer, 3rd editionICD-10International classification of diseases, 10th RevisionBLBurkitt lymphomaBMBaseline modeleBLendemic Burkitt lymphomaEBVEpstein-Barr virusHDIHuman development index 2015KSKaposi sarcomaKSHVKaposi sarcoma-associated herpes virusGCCGlobal childhood cancer microsimulation modelKeywordsChildhood cancerIncidenceEstimatesGlobalCancer registryBurkitt lymphomaKaposi sarcomaGlobal estimates

Original language	English
Article number	101662
Number of pages	12
Journal	Cancer Epidemiology
Volume	71
Issue number	Part B
Early online date	8 Jan 2020
DOIs	https://doi.org/10.1016/j.canep.2019.101662
Publication status	Published - 1 Apr 2021

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10.1016/j.canep.2019.101662

2019 12 09 - Worldwide childhood cancer - revised - Manuscript
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@article{54681eb6332a4d05b14719469ad1f608,

title = "Childhood cancer: Estimating regional and global incidence",

abstract = "Most of the world{\textquoteright}s population is not covered by cancer surveillance systems or vital registration, and worldwide/UN-regional cancer incidence is estimated using a variety of methods. Quantifying the cancer burden in children (<15 years) is more challenging than in adults; childhood cancer is rare and often presents with non-specific symptoms that mimic those of more prevalent infectious and nutritional conditions.MethodsA Baseline Model (BM) was constructed comprising a set of quality assured sex- and age-specific cancer rates derived from the US Surveillance, Epidemiology and End Results (SEER) program, for diagnostic groups of the International Classification of Childhood Cancers (ICCC-3) 3rd edition, and information on a known risk factor for endemic Burkitt lymphoma and Kaposi{\textquoteright}s sarcoma. These rates were applied to global country-level population data for 2015 to estimate the global and regional incidence of childhood cancer. Results were compared to GLOBOCAN 2018, extrapolations from the International Incidence of Childhood Cancer (IICC-3) and estimates from the Global Childhood Cancer (GCC) model (based on IICC-3 data combined with information on health care systems and other parameters).ResultsThe BM estimated 360,114 total childhood cancers occurring worldwide in 2015; 54% in Asia and 28% in Africa. BM estimated standardised rates ranged from ∼178 cases per million in Europe and North America, through to ∼218 cases per million in West and Middle Africa. Totals from GLOBOCAN and extrapolations from the IICC-3 study were lower (44.6% and 34.7% respectively), but the estimate from the GCC model was 10.2% higher. In all models, agreement was good in countries with very high human development index (HDI), but more variable in countries with medium and low HDIs; the discrepancies correlating with registration coverage across these settings.ConclusionDisagreements between the BM estimates and other sources occur in areas where health systems are insufficiently equipped to provide adequate access to diagnosis, treatment, and supportive care. Incorporating aetiological evidence into the BM enabled the estimation of the additional burden of Burkitt lymphoma and Kaposi sarcoma; similar adjustments could be applied to other cancers, as and when information becomes available.AbbreviationsSEERSurveillance, Epidemiology and End Results programIICC-3International incidence of childhood cancer study, 3rd volumeICCC-3International classification of childhood cancer, 3rd editionICD-10International classification of diseases, 10th RevisionBLBurkitt lymphomaBMBaseline modeleBLendemic Burkitt lymphomaEBVEpstein-Barr virusHDIHuman development index 2015KSKaposi sarcomaKSHVKaposi sarcoma-associated herpes virusGCCGlobal childhood cancer microsimulation modelKeywordsChildhood cancerIncidenceEstimatesGlobalCancer registryBurkitt lymphomaKaposi sarcomaGlobal estimates",

author = "Tom Johnston and Friederike Erdmann and Robert Newton and Eva Steliarova-Foucher and Joachim Sch{\"u}z and Eve Roman",

note = "{\textcopyright} 2019 Elsevier Ltd. This is an author-produced version of the published paper. Uploaded in accordance with the publisher{\textquoteright}s self-archiving policy. ",

year = "2021",

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day = "1",

doi = "10.1016/j.canep.2019.101662",

language = "English",

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TY - JOUR

T1 - Childhood cancer

T2 - Estimating regional and global incidence

AU - Johnston, Tom

AU - Erdmann, Friederike

AU - Newton, Robert

AU - Steliarova-Foucher, Eva

AU - Schüz, Joachim

AU - Roman, Eve

PY - 2021/4/1

Y1 - 2021/4/1

N2 - Most of the world’s population is not covered by cancer surveillance systems or vital registration, and worldwide/UN-regional cancer incidence is estimated using a variety of methods. Quantifying the cancer burden in children (<15 years) is more challenging than in adults; childhood cancer is rare and often presents with non-specific symptoms that mimic those of more prevalent infectious and nutritional conditions.MethodsA Baseline Model (BM) was constructed comprising a set of quality assured sex- and age-specific cancer rates derived from the US Surveillance, Epidemiology and End Results (SEER) program, for diagnostic groups of the International Classification of Childhood Cancers (ICCC-3) 3rd edition, and information on a known risk factor for endemic Burkitt lymphoma and Kaposi’s sarcoma. These rates were applied to global country-level population data for 2015 to estimate the global and regional incidence of childhood cancer. Results were compared to GLOBOCAN 2018, extrapolations from the International Incidence of Childhood Cancer (IICC-3) and estimates from the Global Childhood Cancer (GCC) model (based on IICC-3 data combined with information on health care systems and other parameters).ResultsThe BM estimated 360,114 total childhood cancers occurring worldwide in 2015; 54% in Asia and 28% in Africa. BM estimated standardised rates ranged from ∼178 cases per million in Europe and North America, through to ∼218 cases per million in West and Middle Africa. Totals from GLOBOCAN and extrapolations from the IICC-3 study were lower (44.6% and 34.7% respectively), but the estimate from the GCC model was 10.2% higher. In all models, agreement was good in countries with very high human development index (HDI), but more variable in countries with medium and low HDIs; the discrepancies correlating with registration coverage across these settings.ConclusionDisagreements between the BM estimates and other sources occur in areas where health systems are insufficiently equipped to provide adequate access to diagnosis, treatment, and supportive care. Incorporating aetiological evidence into the BM enabled the estimation of the additional burden of Burkitt lymphoma and Kaposi sarcoma; similar adjustments could be applied to other cancers, as and when information becomes available.AbbreviationsSEERSurveillance, Epidemiology and End Results programIICC-3International incidence of childhood cancer study, 3rd volumeICCC-3International classification of childhood cancer, 3rd editionICD-10International classification of diseases, 10th RevisionBLBurkitt lymphomaBMBaseline modeleBLendemic Burkitt lymphomaEBVEpstein-Barr virusHDIHuman development index 2015KSKaposi sarcomaKSHVKaposi sarcoma-associated herpes virusGCCGlobal childhood cancer microsimulation modelKeywordsChildhood cancerIncidenceEstimatesGlobalCancer registryBurkitt lymphomaKaposi sarcomaGlobal estimates

AB - Most of the world’s population is not covered by cancer surveillance systems or vital registration, and worldwide/UN-regional cancer incidence is estimated using a variety of methods. Quantifying the cancer burden in children (<15 years) is more challenging than in adults; childhood cancer is rare and often presents with non-specific symptoms that mimic those of more prevalent infectious and nutritional conditions.MethodsA Baseline Model (BM) was constructed comprising a set of quality assured sex- and age-specific cancer rates derived from the US Surveillance, Epidemiology and End Results (SEER) program, for diagnostic groups of the International Classification of Childhood Cancers (ICCC-3) 3rd edition, and information on a known risk factor for endemic Burkitt lymphoma and Kaposi’s sarcoma. These rates were applied to global country-level population data for 2015 to estimate the global and regional incidence of childhood cancer. Results were compared to GLOBOCAN 2018, extrapolations from the International Incidence of Childhood Cancer (IICC-3) and estimates from the Global Childhood Cancer (GCC) model (based on IICC-3 data combined with information on health care systems and other parameters).ResultsThe BM estimated 360,114 total childhood cancers occurring worldwide in 2015; 54% in Asia and 28% in Africa. BM estimated standardised rates ranged from ∼178 cases per million in Europe and North America, through to ∼218 cases per million in West and Middle Africa. Totals from GLOBOCAN and extrapolations from the IICC-3 study were lower (44.6% and 34.7% respectively), but the estimate from the GCC model was 10.2% higher. In all models, agreement was good in countries with very high human development index (HDI), but more variable in countries with medium and low HDIs; the discrepancies correlating with registration coverage across these settings.ConclusionDisagreements between the BM estimates and other sources occur in areas where health systems are insufficiently equipped to provide adequate access to diagnosis, treatment, and supportive care. Incorporating aetiological evidence into the BM enabled the estimation of the additional burden of Burkitt lymphoma and Kaposi sarcoma; similar adjustments could be applied to other cancers, as and when information becomes available.AbbreviationsSEERSurveillance, Epidemiology and End Results programIICC-3International incidence of childhood cancer study, 3rd volumeICCC-3International classification of childhood cancer, 3rd editionICD-10International classification of diseases, 10th RevisionBLBurkitt lymphomaBMBaseline modeleBLendemic Burkitt lymphomaEBVEpstein-Barr virusHDIHuman development index 2015KSKaposi sarcomaKSHVKaposi sarcoma-associated herpes virusGCCGlobal childhood cancer microsimulation modelKeywordsChildhood cancerIncidenceEstimatesGlobalCancer registryBurkitt lymphomaKaposi sarcomaGlobal estimates

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DO - 10.1016/j.canep.2019.101662

M3 - Article

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VL - 71

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IS - Part B

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