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http://www3.interscience.wiley.com/cgi-bin/abstract/104083946/START
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Online ISSN: 1097-0215 Print ISSN: 0020-7136 Copyright © 2003 Wiley-Liss, Inc. |
Epidemiology
| Increasing incidence of childhood leukemia in Northwest Italy, 1975-98 |
Corrado Magnani 1 2 * , Paola
Dalmasso 1 3, Guido Pastore 1, Benedetto Terracini
1, Marco Martuzzi 4,
Maria Luisa Mosso 1, Franco
Merletti 1 |
| 1Childhood Cancer Registry of
Piedmont, Regional Center for Cancer Epidemiology and Prevention
(CPO Piemonte), Torino, Italy 2Medical Statistics Unit, Department of Medical Sciences, University of Eastern Piedmont at Novara, Novara, Italy 3Medical Statistics Unit, Department of Public Health and Microbiology, University of Torino, Torino, Italy 4World Health Organization, European Center for Environment and Health, Rome, Italy |
| email: Corrado Magnani (corrado.magnani@cpo.it) |
*Correspondence to Corrado Magnani, Childhood Cancer Registry of Piedmont, V. Santena 7, 10126 Torino, Italy
Fax:
+39-011-6336960
Funded by:
Regional Administration of
Piedmont
Italian Association of
Cancer Research
Ministry of University and
Research (MUIR)
| Keywords |
| childhood leukemia • ALL • AnLL • epidemiology • incidence • trends • Italy • cancer registration |
| Abstract |
| Although some childhood cancer registries reported increasing incidence, the evidence and magnitude of time trends in the incidence of childhood leukemia are debated and the scientific evidence is conflicting. Only limited data have so far been supplied from Southern European countries. We present an analysis of the incidence trend of childhood leukemia in Piedmont (NW Italy) in 1975-98, based on data from the population-based childhood cancer registry. The Childhood Cancer Registry of Piedmont has been recording cases of childhood neoplasms since 1967. Procedures have been uniform and are based on an active search for cases and relevant information. Only cases with confirmed residence in Piedmont at diagnosis are included. Eight hundred cases of leukemia (622 acute lymphoblastic [ALL], 133 acute nonlymphoblastic [AnLL], 45 other and unspecified) were recorded in the period 1975-98 considered in our study. Incidence trends were analyzed using piecewise regression and Poisson regression, based on annual incidence rates. As results from the 2 analyses were similar, only the former were reported. In the age group 1-4 years, a statistically significant annual 2.6% increase in incidence rate of ALL (adjusted by age and gender; 95% confidence interval [CI] 1.13-4.13) was estimated. There was no evidence of increase in other age groups. During 1980-98, a statistically significant 4.4% annual increase (95% CI 1.86-6.90) was seen for pre-B-All in the age group 1-4 years. An increase was also seen for T-ALL that was not statistically significant. Sensitivity analyses were conducted, with no relevant differences from the main results. Our data suggest an increasing trend in ALL incidence for children between the ages of 1 and 4 years. These results are unlikely to be explained by changes in quality of data or exhaustiveness in reporting in the study period. The results were not changed in the sensitivity analyses we conducted. Possible causes to be investigated include environmental factors, changes in family size and parental age, socioeconomic conditions and geographical distribution of cases. © 2003 Wiley-Liss, Inc. |
Received: 30 July 2002; Revised: 13 January 2003; Accepted: 17 January 2003
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