Background: Pediatric cancer incidence has been increasing in the United States, despite improvement in pediatric cancer survival. This steady increase in incidence trends is not completely understood but maybe associated with social and environmental factors. In this study we aimed to assess the cumulative incidence, temporal trends, and mortality rates in pediatric cancer. Additionally, we examined sub-group variability in both incidence and mortality rates. Methods: Data from Surveillance, Epidemiology, and End Results (SEER) −18 from 1973–2014 were used for the purpose of analysis in this study. Age-adjusted incidence rates were used to assess temporal trends in cancer among children aged <1–19 years. Univariable and multivariable binomial regression models were used to examine the association between race and cancer mortality while adjusting for potential confounders. Results: There were 92,594 cancer diagnoses during this period. White children comprised 74,758, (80.7%), black children 10,030, (10.8%), and other races 6648, (7.2%). Overall the age-adjusted cumulative incidence was slightly higher among white children (16.4%) than black children (12.4%) and other (13.0%). Children aged 15–19 years and those in metropolitan regions were more likely to be diagnosed with pediatric cancer. Relative to females, males were 16% more likely to die from the disease [adjusted Risk Ratio (aRR): 1.16, 95% Confidence Interval (CI): 1.09–1.22]. Additionally, compared to white children, black children had higher mortality rates [(aRR): 1.37, 99% CI: 1.23–1.52]. Conclusions: There is an increasing trend in pediatric cancer incidence; while white children have the highest incidence, black children and males indicated a survival disadvantage, indicative of racial and sex variability in overall pediatric cancer in the United States.
背景：尽管儿童癌症生存率有所改善，但美国儿童癌症发病率仍在持续上升。这种发病趋势的稳步增长尚未完全明确，可能与社会环境因素相关。本研究旨在评估儿童癌症的累积发病率、时间趋势及死亡率，并进一步分析不同亚组在发病率和死亡率方面的差异性。 方法：本研究采用美国国家癌症研究所"监测、流行病学和最终结果"（SEER）数据库1973-2014年间第18版数据进行分析。通过年龄标准化发病率评估0-19岁儿童癌症的时间趋势，运用单变量及多变量二项回归模型分析种族与癌症死亡率的相关性，并对潜在混杂因素进行校正。 结果：研究期间共记录92,594例癌症确诊病例，其中白人儿童74,758例（80.7%），黑人儿童10,030例（10.8%），其他种族6,648例（7.2%）。总体年龄标准化累积发病率显示白人儿童（16.4%）略高于黑人儿童（12.4%）及其他种族（13.0%）。15-19岁年龄段及大都市区域儿童更易被诊断为癌症。相较于女性患者，男性患者死亡风险增加16%[校正风险比（aRR）：1.16，95%置信区间（CI）：1.09-1.22]。与白人儿童相比，黑人儿童死亡率显著更高[校正风险比（aRR）：1.37，99%置信区间（CI）：1.23-1.52]。 结论：美国儿童癌症发病率呈上升趋势，白人儿童发病率最高，但黑人儿童与男性患者生存劣势明显，表明美国儿童癌症总体存在种族与性别差异。
肿瘤(癌症)患者之家