Outcomes for Children and Adolescents With Cancer: Challenges for the Twenty-First Century
Outcomes for Children and Adolescents With Cancer: Challenges for the Twenty-First Century
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DOI：
10.1200/jco.2009.27.0421
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发表时间：
2010-05-20
影响因子：
45.3
通讯作者：
Reaman, Gregory H.
中科院分区：
文献类型：
--
作者：
Smith, Malcolm A.;Seibel, Nita L.;Reaman, Gregory H.
PurposeThis报告提供了一个概述，目前儿童癌症的统计，以促进过去的研究发现的影响，结果的分析，并提供必要的信息，优先考虑未来的研究方向。MethodsIncidence和生存数据的儿童癌症来自监测，流行病学，和最终结果9（SEER 9）登记，和死亡率数据是基于美国各州向疾病控制和预防中心报告的死亡人数。结果儿童癌症发病率从1975年到2006年显著增加，其中急性淋巴细胞白血病的发病率增加最为显著。1975年至2006年，儿童癌症死亡率下降了50%以上。在这32年期间，白血病和淋巴瘤的死亡率显著下降，但1998年后下降速度有所减缓。至于其他儿童癌症，1975年至1996年期间死亡率显著下降，1996年至2006年期间保持稳定。观察到所有类别的儿童癌症研究的生存率增加，增加的程度和时间步伐因诊断而异。1975年至2006年，由于发现和应用了更有效的治疗方法，美国避免了1000例儿童恶性癌症死亡在此期间持续成功地降低儿童癌症死亡率将需要新的治疗模式，建立在对促进特定儿童癌症生长和存活的分子过程的更多理解的基础上。
PurposeThis report provides an overview of current childhood cancer statistics to facilitate analysis of the impact of past research discoveries on outcome and provide essential information for prioritizing future research directions.MethodsIncidence and survival data for childhood cancers came from the Surveillance, Epidemiology, and End Results 9 (SEER 9) registries, and mortality data were based on deaths in the United States that were reported by states to the Centers for Disease Control and Prevention by underlying cause.ResultsChildhood cancer incidence rates increased significantly from 1975 through 2006, with increasing rates for acute lymphoblastic leukemia being most notable. Childhood cancer mortality rates declined by more than 50% between 1975 and 2006. For leukemias and lymphomas, significantly decreasing mortality rates were observed throughout the 32-year period, though the rate of decline slowed somewhat after 1998. For remaining childhood cancers, significantly decreasing mortality rates were observed from 1975 to 1996, with stable rates from 1996 through 2006. Increased survival rates were observed for all categories of childhood cancers studied, with the extent and temporal pace of the increases varying by diagnosis.ConclusionWhen 1975 age-specific death rates for children are used as a baseline, approximately 38,000 childhood malignant cancer deaths were averted in the United States from 1975 through 2006 as a result of more effective treatments identified and applied during this period. Continued success in reducing childhood cancer mortality will require new treatment paradigms building on an increased understanding of the molecular processes that promote growth and survival of specific childhood cancers.