Childhood cancer incidence in Cuba, 2001 to 2003.

INTRODUCTION: Estimating childhood cancer incidence globally is hampered by lack of reliable data and uniform age limits for classifying and analyzing data reported. In Cuba, cancer data has been systematically gathered and processed by the National Cancer Registry (NCR) since 1964. The International Classification of Childhood Cancer (ICCC) is currently recommended for registering neoplasms in the population aged < or =19 years. Cancer incidence data published by the Cuban Ministry of Public Health, however, uses ICCC diagnostic groups for the population aged <15 years, and topographic sites for the population aged > or =15 years. OBJECTIVE: The objectives of this study are to describe cancer incidence in the Cuban population aged < or =19 years in 2001-2003 using the ICCC, as well as geographic distribution of incidence by sex and by principal diagnostic groups. METHODS: A descriptive study of cancer incidence in the population aged < or =19 years was conducted using NCR data for 2001-2003. ICCC diagnostic groups and subgroups were used, and 5 age groups (<1, 1-4, 5-9, 10-14 and 15-19 years) were analyzed. Total incidence and percentages for each diagnostic group were calculated. Number of cases in each diagnostic group and subgroup was also recorded by age group, and age-specific rates per 100,000 population aged < or =19 years (ASR) and age-adjusted rates to the standard world population aged < or =19 years (AAR) were calculated. AARs for leukemias, lymphomas and central nervous system (CNS) tumors were used to analyze childhood cancer risk by sex and geographical distribution in the country's 14 provinces and Isle of Youth Special Municipality. RESULTS: In 2001-2003, the NCR reported 1285 new cancer cases in the population aged < or =19 years for an overall incidence of 13.9 per 100,000 population aged < or =19 years (AAR). Highest risk was found in children aged <1 year with an ASR of 21.9 per 100,000 population aged < or =19 years. Leukemias, lymphomas and central nervous system tumors comprised 61.1% of new cases, and geographic distribution of these diagnostic groups varied by sex. Childhood cancer risk was highest for males in Ciego de Avila, Villa Clara and the Isle of Youth Special Municipality and highest for females in Sancti Spiritus, Villa Clara and Cienfuegos. CONCLUSIONS: Incidence of childhood cancer in Cuba conforms to rates reported internationally and to the incidence pattern most common in Latin America. Further research is recommended to examine risk factors influencing geographical variations in incidence within Cuba.