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Population-based incidence of childhood leukaemias and lymphomas in Spain (1993–2002)

Marcos-Gragera, Rafaela b; Cervantes-Amat, Martaa; Vicente, Maria Luisac; de Sanjosé, Silviaf; Guallar, Elenac; Godoy, Catalinac; Calvo, Carlotag; Giraldo, Pilarh i; Sant, Milenaj; Peris-Bonet, Rafaeld; Carmen Martos, Mariae i

European Journal of Cancer Prevention: July 2010 - Volume 19 - Issue 4 - p 247-255
doi: 10.1097/CEJ.0b013e328339e2f3
Research Paper: Cancer Registry

The aim of this study was to estimate the incidence of leukaemias and lymphomas in children according to the International Classification of Childhood Cancer third edition (ICCC-3) in the population covered by the Girona, Valencia, and Zaragoza population-based cancer registries and compare it with the incidence rates in other European countries. All haematological malignancies (HMs) registered between 1993 and 2002 in children below 15 years of age were included in the study. Pathological and haematological diagnoses were reviewed, recoded according to International Classification of Diseases for Oncology-3 and reclassified on the basis of ICCC-3. Sex and age-adjusted incidence rates were calculated, using the world population as standard. Five hundred and seventy-one HMs were registered in the Girona, Valencia and Zaragoza Cancer Registries during the study period. According to ICCC-3, precursor cell leukaemias were the most frequent HMs in children and constituted 60% of all HMs (an age-adjusted incidence rate of 42.7 per million children-years). The second most frequent childhood HM was Hodgkin lymphoma (11.2% of all HMs), yielding an age-adjusted standardized incidence rate of 6.3 per million children-years. With regard to myeloid lineage, acute myeloid leukaemias were the most frequent with a rate of 7.9 per million children-years. The standardized incidence rates for lymphoid leukaemia (1.19) and Burkitt lymphoma (3.94) were statistically higher than the rates observed in Europe. Compared with European data, Spain has a high incidence of lymphoid leukaemias and lymphomas. In particular, a high incidence of Burkitt lymphoma was observed. The causes of this geographical variation are still unknown.

aGirona Cancer Registry-Catalan Cancer Plan, Department of Health

bDepartment of Nursing, University of Girona, Girona

cCommunity Valenciana Childhood Cancer Registry, Epidemiology Area, Public Health Department, Consellería de Sanitat, Generalitat Valenciana

dNational Childhood Cancer Registry (RNTI-SEOP), UVEG

eCentro Superior de Investigación en Salud Pública, Valencia

fUnit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, CIBERESP, L'Hospitalet de Llobregat, Barcelona

gOncopaediatric Unit, Paediatric Service, University Hospital Miguel Servet

hHaematology Services, University Hospital Miguel Servet

iZaragoza Cancer Registry, Institute of Health Sciences of Aragon, Zaragoza, Spain

jDepartment of Preventive and Predictive Medicine, Fondazione IRCCS ‘Istituto Nazionale dei Tumori’, Milan, Italy

Correspondence to Dr Rafael Marcos-Gragera, PhD, MD, MPH, Unitat d'Epidemiologia i Registre de Càncer de Girona, Institut Català d'Oncologia-Girona, Passatge Farinera Teixidor, núm 1, 1r-2a, 17005 Girona, Spain

Tel: +34 972 207 406; fax: +34 972 206 180;


Rafael Marcos-Gragera and Marta Cervantes equally contributed to this study

Received 21 February 2009 Accepted 14 March 2010

© 2010 Lippincott Williams & Wilkins, Inc.