Patterns and temporal trends in the incidence of childhood and adolescence cancer in Cyprus 1998–2017: A population-based study from the Cyprus Paediatric Oncology Registry

ElsevierVolume 80, October 2022, 102239Cancer EpidemiologyHighlights•

The first ever population-based cancer epidemiology study in Cypriot 0–19-year-olds.

Cancer incidence rates (1998–2017) in Cypriot 0–19-year-olds among world’s highest.

Cancer rates in this age group were higher only in Italy and Belgium.

No significant temporal variation for all cancer groups except for thyroid cancer.

Leukaemias most frequent; lymphomas, thyroid cancer more frequent than brain tumours.

AbstractBackground

Despite its rarity, cancer in children and adolescents (CAC) is a major health issue worldwide. The lack of appropriate cancer registries is an obstacle for defining its incidence and survival, and informing cancer control. As in Cyprus, CAC epidemiology has not previously been comprehensively examined, we determined incidence rates and temporal trends of cancer in the 0–19 age group during 1998–2017.

Methods

We established the population based Paediatric Oncology Registry of Cyprus (PORCY) for the period 1998–2017. World age standardised incidence rate per million children and adolescents per year (ASRW) were calculated and time trends were assessed using Joinpoint regression analysis. Comparisons were made with other countries using the International Incidence of Childhood Cancer, third volume.

Results

For all cancers combined, for ages 0–19-years, ASRW was 203.54 (95% CI 189.49, 217.59) one of the highest rates globally. The most frequent CAC were leukaemias followed by lymphomas, specified epithelial neoplasms and central nervous system tumours, differing to what is described in most other countries. For all cancers, both combined and individual types, except thyroid carcinoma (where incidence was rising), no significant temporal variation was found.

Conclusions

To inform cancer control activities, we conducted the first ever population-based epidemiological study of childhood and adolescent cancer (0–19 years) in Cyprus. The striking findings indicate high overall incidence rates that are among the world’s highest, a higher frequency of lymphomas and thyroid cancer than brain tumours, and rising incidence for thyroid, but not for other, cancers. These novel findings, will help the formulation of hypotheses to provide explanation for the high rates for all CAC in Cyprus and may contribute to the global efforts for improving prevention of cancer in this age group.

AbbreviationsAAPC

average annual percentage change in the rate

AMH

Archbishop Makarios III Hospital

Nicosia, Cyprus, APC

annual percentage change in the rate

ASR

age specific incidence rate, per million children and adolescents per year

ASRW

age standardised incidence rate (Segi 1960 World Standard Population)

CAC

childhood and adolescence cancer

cIR

crude incidence rate, number of cases per million children and adolescents, per year

CNCR

Cyprus National Cancer Registry

CNS

central nervous system

DCO%

proportion of death certificate only cases

ICCC3

International Childhood Cancer Classification 3rd edition

IICC3

International Incidence of Childhood Cancer 3

MECC

Middle East Cancer Consortium

MI%

mortality to incidence ratio

MV%

microscopically verified

POH

Paediatric Oncology/Hematology Clinic

PORCY

Pediatric Oncology Registry of Cyprus

SEN

specified epithelial neoplasms

Keywords

Children and adolescents

Cancer

Incidence and trends

Childhood cancer registry

Cyprus

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