Childhood Cancer Registry of the Province of Torino: survival patterns since 1967 and update of incidence rates

Neurofibromatosis and Malignant Childhood Cancers: A Survey in Italy, 1970–83

Neural tumors, Wilms’ tumor, rhabdomyosarcoma and several types of leukemia have been previously described in association with neurofibromatosis (NF). In a nation-wide collection of cases in Italy, 15 children (0–14 years of age) with NF and cancer or leukemia were identified; 13 of them had been diagnosed with cancer between 1976–83. The expected number of children with cancer and NF in 1976–83 was 4.48. The distribution of tumor types was different from that found in the general population, with a higher proportion of tumors of neural crest origin as well as soft tissue sarcomas. In 7/15 the family history was positive for NF; in 5/7 the individuals affected included the mother and/or a maternal relative.

Childhood cancer mortality in the European Community, 1950-1989

A descriptive study on childhood cancer mortality was carried out in the European Community (EC) covering the period 1950-1989. An annual total of 3392 cancer deaths were seen among children in the EC during the period 1979-1988, yielding an age-standardised cancer mortality rate of 50 per 10(6). Leukaemia was the most prevalent cause of death among children with cancer (39%). Excess mortality was observed among boys for cancers at all sites combined and for cancers at specific sites, exclusive of malignant tumours of the kidney. This excess is presumed to be due mainly to sex differences in incidence. Markedly higher mortality rates of childhood cancer were seen in southern countries of the EC than in central and northern countries. This difference appeared to be due mainly to differences in cancer incidence among the countries and to a lesser degree to differences in treatment and survival. An overall decline in mortality from childhood cancer in the EC occurred from the early 1960s. In spite of the improvements in survival, however, childhood cancer remains a major cause of death in the EC, affecting about 15% of children between the ages of 1 and 14.

Childhood cancer registry of the Province of Torino, Italy. Survival, incidence, and mortality over 20 years

Incident childhood cancers in the Province of Torino, Italy (population aged 0 to 14 years averaging 0.5 million) have been registered since 1967. Four population-based exhaustive surveys have been done to collect cases diagnosed during the periods 1967 to 1969, 1970 to 1975, 1976 to 1981, and 1982 to 1986. For each registered child, vital status on June 30, 1988 was assessed. This article reports incidence, mortality, and survival rates over a 20-year period. A statistically significant trend toward an increased incidence of soft tissue sarcomas was identified. Statistically insignificant trends included an increased incidence of brain tumors (probably reflecting improved diagnostic procedures) and a decreased incidence of thyroid tumors. Incidence rates of leukemias in the first year of life tended to decrease. As expected, survival rates of some childhood cancers dramatically improved throughout the 20-year period; this occurred in leukemias, brain tumors, soft tissue sarcomas, and renal tumors. Survival rates are compared with observations in comparable population-based series.

Late deaths and second primary malignancies among long-term survivors of childhood cancer: an Italian multicentre study

A multicentre registry of children who had been successfully removed from therapy for some common childhood cancers (Hodgkin's disease, non-Hodgkin's lymphoma, neuroblastoma, nephroblastoma, acute lymphatic leukaemia and other leukaemias) was established in Italy in 1981. The present study describes mortality and occurrence of second primary malignancies (SPMs) among 1467 children who were alive when the registry was established. Follow-up ended on December 31, 1983 for mortality and 1 year later for the occurrence of SPMs. Sixty-seven deaths were recorded, 11 of which were due to causes other than progression of the original disease. Eleven incident SPMs were identified (i.e. 3 acute myeloid leukaemias, 3 thyroid carcinomas, 1 bilateral breast carcinoma, 1 liver malignant mesenchymoma, 1 astrocytoma, 1 chondrosarcoma and 1 osteosarcoma) corresponding to an incidence rate of 2.1/1000 patient-years at risk. Anecdotal reports were collected regarding 2 further SPMs (a thyroid carcinoma and a myeloid leukaemia) as well as several benign tumours, including 2 mammary fibroadenomas.