Current Trends Childhood Cancers -- New Jersey, 1979-1985

In New Jersey, cancers among children aged 0-14 years account for fewer than 1% of all cancers diagnosed annually; however, childhood cancers account for the greatest number of years of potential life lost from cancer. This report summarizes a study by the New Jersey State Department of Health (NJSDH) that determined the incidence and death rates for the most frequent cancers among children aged 0-14 years in New Jersey during 1979-1985; these rates are compared with those for the United States for a comparable period.

Incidence data were obtained from the New Jersey State Cancer Registry. The childhood cancer incidence data analyzed included the most frequent cancers among children reported to the NJSDH from hospitals, laboratories, and private practi tioners, and cases identified through review of New Jersey death certificates. The mortality data were extracted from the state's vital statistics mortality data tapes. Incidence and death rates were age-adjusted to the 1970 U.S. population. National estimated incidence rates were obtained from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute*; death rates were based on national data and were age-adjusted to the 1970 U.S. population (1).

From 1979 through 1985, incidence rates of childhood cancers remained relatively stable in New Jersey, while death rates decreased steadily (Figure 1). Although incidence rates for total childhood cancer in New Jersey were higher than the national rates, death rates for New Jersey were virtually identical to U.S. rates.

During the 7-year period, cancer was diagnosed annually in an average of 240 children in New Jersey, most (83%) of whom were white. Each year, an average of 64 children died from cancers--leukemia (31% of deaths), brain and central nervous system cancers (20%), lymphomas (11%), renal cancer (6%), bone and joint cancer (4%), eye and orbit cancer (3%), and all other cancers (24%). This distribution is similar to that for cases observed in the SEER Program, which identified an average of 7800 cases of childhood cancers yearly. During the 7-year period, death rates from lymphomas decreased among children in the United States and in New Jersey. Reported by: ME Petrone, MD, DM Harlan, MS, HC Lewis, MPH, T Abe, MSW, Div of Epidemiology and Communicable Disease Control, Cancer Registry and Data Applications Programs, WE Parkin, DVM, K Spitalny, MD, State Epidemiologist, New Jersey State Dept of Health.

Editorial Note

Editorial Note: Although the overall incidence of cancer is low among children, cancer is the major cause of deaths attributed to disease in children in the United States (2). During 1950-1985, the incidence rate of childhood cancers increased by 32%, while the death rate decreased 56% (1)--primarily because of advances in treatment of many forms of childhood cancers. In 1991, an estimated 7800 new cases of childhood cancers will occur in the United States, and approximately 1500 children will die from cancers (2).

New Jersey accounts for approximately 3.7% of the estimated 7800 childhood cancers that occur annually in the United States. Although the incidence rate of childhood cancers in New Jersey was higher than that of the United States, similarities in death rates suggest that health-care providers and programs in New Jersey have been successful in aggressively screening, identifying, and treating childhood cancers.

The NJSDH shares cancer registry data and collaborates with other institutions in the state to address childhood cancers and other diseases. For example, the New Jersey Pediatric Hematology Oncology Network has collaborated with the NJSDH to develop a statewide neonatal hemoglobinopathy screening program (3). Five institutions have been designated as regional treatment centers to confirm initial screening diagnosis, educate parents about the diseases, and provide comprehensive treatment for sickle cell disease and other hemoglobinopathies. In addition, the state, local, professional, and community pediatric networks have assisted in clarifying the epidemiology of childhood cancers in New Jersey. Parents can assist in early detection of childhood cancers by ensuring that children are evaluated for problems such as unexplained fatigue or fever, frequent headaches, unusual masses or swelling, increased bruising, and unexplained weight loss (2).

References

1. National Institutes of Health. 1987 Annual cancer statistics review. Bethesda, Maryland: US Department of Health and Human Services, Public Health Service, 1988; NIH publication no. 87-2789.

2. American Cancer Society. Cancer facts and figures--1991. Atlanta: American Cancer Society, 1991.

3. Donaldson MH. New Jersey pediatric hematology oncology. NJ Med 1990;87:927-30.

*The SEER Program comprises cases from nine population-based cancer registries throughout the United States.

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