The incidence of leukemia ranks first, and the latest disclosure of cancer data in children in China ...

Of all cancers in children and adolescents, leukemia had the highest overall incidence at 39.
34 per million people
.


Written by | Ling Jun source | On September 24, 2022,

a study published online by The Lancet revealed the cancer situation
in children (0-14 years old) and adolescents (15-19 years old) in China.

Studies have shown that between January 2018 and December 2020, a total of about 121145 children and adolescents in China were diagnosed with cancer
.
Leukemia is the most common cancer, accounting for nearly 30%
of all confirmed cases in children aged 1-4 years.
The highest incidence of cancers in adolescents is malignant epithelial tumors and melanoma
.

The data suggest that compared with 2000 to 2015, the cancer burden of children and adolescents in China has increased
.
In addition, the reported incidence of cancer in general also rises
with the increase of HDI (Human Development Index).


The study was completed by the team of Professor Ni Xin of Beijing Children's Hospital affiliated to Capital Medical University, and the data came from the National Children's Cancer Monitoring Center, the National Hospital Quality Monitoring System and the public database, covering 31 provinces, autonomous regions and municipalities directly under the Central Government in mainland China
.

From 2018 to the end of 2020, the age-standardized incidence of cancer in children and adolescents in China was 126.
48/million people, with the highest incidence of cancer among children under 5 years of age and the lowest incidence in children aged 5-9 years, and then gradually increasing
with age.
Of all cancers, leukemia had the highest overall incidence at 39.
34 per million people
.

Among children of different ages and genders with cancer incidence
in children and adolescents (0-14 years old), the incidence of leukemia was 43.
33 per million people, and central nervous system tumors (19.
59 per million people) and lymphoma (11.
54 per million people) ranked 2nd and 3rd in the incidence of childhood cancer
.

Among them, common central nervous system tumors in children include astrocytoma (5.
25/million people) and intracranial and spinal canal embryonic tumors (3.
99/million people
).
Neuroblastoma and ganglion neuroblastoma are the most common cancers in children under 1 year of age, accounting for 15.
84% and 14.
35%
of all cases in boys and girls, respectively.

It is worth noting that this study found that leukemia accounts for about 32% of childhood cancers, lymphoma accounts for about 9.
7%, and the remaining nearly 60% are solid tumors, indicating that the epidemiological burden of solid tumors in children has been underestimated
before.

Among adolescents (15-19 years old), malignant epithelial cancer and melanoma ranked first (30.
39/million people) in the incidence
of leukemia stratified by age and sex among adolescents (30.
39/million people), including thyroid cancer (18.
12/million people), nasopharyngeal cancer (2.
69/million people), and colorectal cancer (2.
1/million people
).
Among them, thyroid cancer has the highest incidence among girls aged 15-19 years, at 29.
56/million people
.

Leukemia (30.
08/million people) and central nervous system tumors (16.
75/million people) ranked second and third
in the incidence of cancer in adolescents, respectively.

The more developed the economy of the top ten high-incidence cancers

stratified by age and sex in children and adolescents, the higher the incidence of cancer?
The study also found that despite differences between different age groups, the overall incidence of cancer increased with HDI, that is, the level of socio-economic development, with the total incidence of cancer being 1.
39 times that
of the lowest HDI in the areas with the highest HDI.

HDI is ranked from lowest to highest, corresponding to the approximate province/municipality
, but the data also suggests that the trend is more pronounced
among children.
This may be closely related
to the distribution of access to medical resources.
Including pediatric cancer diagnosis and treatment institutions, pediatric beds, number of doctors, etc.
, this study also reported for the first time the accessibility of
cancer diagnosis and health services in China.

For example, in the very low HDI area, there were only 0.
04 cancer treatment facilities, 11.
84 pediatric beds, 0.
76 pediatricians and 0.
48 pathology professionals per 1,000 square kilometers, and the relevant data were 3.
23, 306.
66, 86.
4 and 88.
82
in the highest HDI areas, respectively.

The density
of clinics, pediatric beds, pediatricians, and pathologists in different HDI regions has led to significant cross-regional visits
.
Among all new cases of cancer in children and adolescents, the proportion of confirmed cases across regions reached 22.
16%.

In areas with the lowest HDI, more than 1/3 of cancers are diagnosed
outside the province.
Specific to cancer, the highest proportion of inter-provincial confirmed cases is retinoblastoma (56.
56%)
.

The researchers believe that unequal access to health care, including the increase in non-medical costs and the inconvenience of long-distance travel for children, is a barrier to early diagnosis of cancer, resulting in lower rates of childhood cancer reported in less developed areas than in developed areas
.

However, unlike children, the incidence of most cancers in adolescents shows a trend
of decline with the improvement of medical service capacity.
The researchers analyzed that this may be because in developed regions, some cancers can be diagnosed early in childhood, and emphasize the importance of early detection of
cancers.

Based on the above results, researchers recommend that cancer incidence and access to health care in
children and adolescents include:

• In the post-pandemic period, relevant departments need to increase the allocation of resources to improve the number of
  medical facilities and pediatric oncology professionals in underdeveloped areas.
  
  
• Integration between primary health-care institutions, maternal and child health hospitals, regional child health centres and national child health centres should be strengthened, particularly in regions with
  low access to health services.
  
  
• As one of the effective measures to narrow the gap in medical accessibility between regions, Internet medical services and artificial intelligence medical care should be continuously strengthened
  .
  
  
• Targeted early diagnosis of cancer programmes are necessary, such as through eye screening and vision assessment in children aged 0-6 years nationwide, and universal access to early diagnosis
  of retinoblastoma.
  

Source: Medical Proofreading: Zang Hengjia Editor: Tian Dongliang
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