French Guiana is a French territory in South America. The exposome of persons living there is quite different from that in mainland France and the ethnic make-up of the population is also quite different. Poverty is also widespread with difficulties in accessing care magnified by the low medical-professional density. In this singular context, we aimed to measure the incidence of pediatric cancers and to compare it with other continents. We used French Guiana’s certified cancer registry to study this between 2003 and 2017. Incidences were standardized using the world population with three strata: 0–4 years, 5–9 years, and 10–14 years. There were 164 solid tumors or hematologic malignancies diagnosed in children under the age of 15 (92 in boys and 72 in girls). Over the study period, the standardized incidence rate was 14.1 per 100,000 among children aged under 15 years. There was no significant trend during the study period. The three most common causes of cancer were leukemias—mostly lymphoblastic—CNS tumors, and sarcoma. The standardized incidence of pediatric cancers in French Guiana was similar to those in Western Europe and North America. As others have discovered, we found that males tended to be more likely to develop cancer, notably leukemia, CNS tumors, sarcoma, and retinoblastoma. As elsewhere, the predominant cancer types changed with age. Our initial assumption was that given the singular context of French Guiana, there may have been differences in pediatric cancer incidences. Here we showed that overall, contrary to our assumption and to trends in tropical countries, the incidence of pediatric cancers was in a range between Western Europe and North America with some apparent but non-significant differences in the main types of cancers observed in global statistics. Quality cancer registry data in this tropical region confirm the suspicion that lower incidences in tropical low- and middle-income countries are likely to result from incomplete diagnosis and data collection.
法属圭亚那是位于南美洲的法国海外领地。当地居民的暴露组与法国本土存在显著差异，人口种族构成亦迥然不同。该地区贫困现象普遍，加之医疗专业人员密度低，导致就医困难问题尤为突出。在此特殊背景下，本研究旨在测算儿童癌症发病率，并与各大洲数据进行对比。我们利用法属圭亚那官方癌症登记系统，对2003年至2017年间的病例进行研究。发病率采用世界人口标准进行年龄标准化，按0-4岁、5-9岁和10-14岁三个年龄段分层分析。 研究期间共确诊164例15岁以下儿童实体肿瘤或血液系统恶性肿瘤（男性92例，女性72例）。15岁以下儿童标准化发病率为14.1/10万，研究期间未发现显著变化趋势。三大主要癌症类型为白血病（以淋巴细胞白血病为主）、中枢神经系统肿瘤和肉瘤。法属圭亚那儿童癌症标准化发病率与西欧和北美地区相近。与既往研究一致，我们发现男性儿童更易罹患癌症，特别是在白血病、中枢神经系统肿瘤、肉瘤和视网膜母细胞瘤方面。与其他地区相同，主要癌症类型随年龄增长呈现规律性变化。 我们最初假设，鉴于法属圭亚那的特殊环境，其儿童癌症发病率可能存在差异。但研究结果显示：总体而言，与我们的假设及热带国家普遍趋势相反，该地区儿童癌症发病率实际处于西欧与北美区间范围内，虽在全球统计数据中主要癌症类型存在某些表观差异，但均未达到统计学显著性。这一热带地区高质量的癌症登记数据证实了学界长期存在的推测——热带中低收入国家较低的癌症发病率很可能源于诊断和数据收集的不完整性。
Incidence of Pediatric Cancers in French Guiana: How Does It Compare to Global Estimates?
肿瘤(癌症)患者之家