Incidence and time trends of childhood hematological neoplasms: a 36-year population-based study in the southern European context, 1983-2018.

Background: Hematological neoplasms (HNs) are the first and most common childhood cancers globally. Currently, there is a lack of updated population-based data on the incidence of these cancers in the Spanish pediatric population. This study aimed to describe the incidence and incidence trends of HNs in children (0-14 years) in Spain using data from the Spanish Network of Cancer Registries and to compare the results with other southern European countries. Methods: Data were extracted from 15 Spanish population-based cancer registries between 1983 and 2018. Cases were coded according to the International Classification of Diseases for Oncology, third edition, first revision, and grouped according to the International Classification of Childhood Cancer, third edition. Crude rates (CRs), age-specific rates, and age-standardized incidence rates using the 2013 European population (ASRE) were calculated and expressed as cases per 1,000,000 child-years. Incidence trends and annual percentage changes (APCs) were estimated. Results: A total of 4,747 HNs were recorded (59.5% boys). Age distribution [n (%)] was as follows: <1 year, 266 (5.6%); 1-4 years, 1,726 (36.4%); 5-9 years, 1,442 (30.4%); and 10-14 years, 1,313 (27.6%). Leukemias were the most common group, with a CR and an ASRE of 44.0 (95%CI: 42.5; 45.5) and 44.1 (95%CI: 42.6; 45.7), respectively. The CR and ASRE of lymphomas were 20.1 (95%CI: 19.1; 21.1) and 20.0 (95%CI: 19.0; 21.1), respectively. The comparable incidence rates between our results and those of other southern European countries were similar for lymphomas, while some differences were observed for leukemias. From 1988 to 2016, the trend in leukemia incidence was stable for both sexes, with an APC of 0.0 (95%CI: -0.5; 0.7), whereas a constant overall increase was observed for lymphoma in both sexes, with an APC of 1.0 (95%CI: 0.4; 1.6). Conclusion: Leukemias are the most common HNs in children, and their incidence has remained stable since 1988, whereas the incidence of lymphomas has increased every year. Lymphoma incidence is like that of other southern European countries, while leukemia incidence is similar only to that of southwestern European countries. Collaborative cancer registry projects allow for assessing epidemiological indicators for cancers such as HNs, which helps health authorities and clinicians provide more knowledge about these malignancies.

Incidence and survival of lymphoid neoplasms in Spain, 2002-2013: A population-based study from the Spanish Network of Cancer Registries (REDECAN).

Introduction: The aim of this study was to describe incidence, incidence trends and survival patterns of lymphoid neoplasms (LNs) and its subtypes in Spain in the period 2002-2013 using data from the Spanish Network of Cancer Registries (REDECAN). Materials and Methods: Data were extracted from 13 Spanish population-based cancer registries. LNs incident cases were codified using the International Classification of Diseases for Oncology, third edition (ICD-O-3) and grouped according to the WHO 2008 classification. Age-standardized incidence rates to the 2013 European standard population (ASIRe) were obtained. Poisson regression models were used to analyze trends in incidence rates and estimate the annual percentage change (APC) for each subtype. The number of cases in Spain for 2023 was estimated by applying the estimated age-specific rates for the year 2023 to the 2023 Spanish population. Observed survival (OS) was estimated by the Kaplan-Meier method and net survival (NS) by the Pohar-Perme method. Sex- and age-specific estimates of 5-year NS were calculated, as well as its changes according to two periods of diagnosis (2002-2007 and 2008-2013). Results: LNs accounted for 69% (n=39,156) of all hematological malignancies (n=56,751) diagnosed during the period of study. Median age at diagnosis was 67 years (interquartile range (IQR) = 52-77). The overall ASIRe was 34.23 (95% confidence interval (CI): 33.89, 34.57) and showed a marked male predominance in almost all subtypes (global sex ratio = 1.45). During the study period, incidence trends of LNs remained stable (APC: 0.3; 95% CI: -0.1, 0.6), nevertheless some subtypes showed statistically significant variations, such as LNs NOS category (APC: -5.6; 95% CI: -6.8, -4.3). Around 17,926 new cases of LNs will be diagnosed in 2023 in Spain. Survival rates differed considerably across age-groups, while they were similar between men and women. Five- year NS was 62.81% (95% CI: 62.1, 63.52) for all LNs, and varied widely across LNs subtypes, ranging from 39.21% to 90.25%. NS for all LNs improved from the first period of diagnosis to the second one, being 61.57% (95% CI: 60.56, 62.61) in 2002-2007 and 64.17% (95% CI: 63.29, 65.07) in 2008-2013. Conclusions: This study presents the first complete and extensive population-based analysis of LNs incidence and survival in Spain. These population-based data provide relevant information to better understand the epidemiology of LNs in Southern Europe and it features some useful points for public health authorities and clinicians. However, additional improvements regarding the registration of these hematological neoplasms can be implemented.

Survival of Breast Cancer by Stage, Grade and Molecular Groups in Mallorca, Spain.

The aims of this study are: (1) to determine cause-specific survival by stage, grade, and molecular groups of breast cancer, (2) to identify factors which explain and predict the likelihood of survival and the risk of dying from this cancer; and (3) to find out the distribution of breast cancer cases by stage, grade, and molecular groups in females diagnosed in the period 2006-2012 in Mallorca (Spain). We collected data regarding age, date and diagnostic method, histology, laterality, sublocation, pathological or clinical tumor size (T), pathological or clinical regional lymph nodes (N), metastasis (M) and stage, histologic grade, estrogen and progesterone receptors status, HER-2 expression, Ki67 level, molecular classification, date of last follow-up or date of death, and cause of death. We identified 2869 cases. Cause-specific survival for the entire sample was 96% 1 year after diagnosis, 91% at 3 years and 87% at 5 years. Relative survival was 96.9% 1 year after diagnosis, 92.6% at 3 years and 88.5% at 5 years. The competing-risks regression model determined that patients over 65 years of age and patients with triple negative cancer have worse prognoses, and as stages progress, the prognosis for breast cancer worsens, especially from stage III.

Cancer Survival in Adults in Spain: A Population-Based Study of the Spanish Network of Cancer Registries (REDECAN).

The assessment of cancer survival at the population level is essential for monitoring progress in cancer control. We aimed to assess cancer survival and its trends in adults in Spain. Individual records of 601,250 adults with primary cancer diagnosed during 2002-2013 and followed up to 2015 were included from 13 population-based cancer registries. We estimated net survival up to five years after diagnosis and analyzed absolute changes between 2002-2007 and 2008-2013. Estimates were age-standardized. Analyses were performed for 29 cancer groups, by age and sex. Overall, age-standardized five-year net survival was higher in women (61.7%, 95% CI 61.4-62.1%) than in men (55.3%, 95% CI 55.0-55.6%), and ranged by cancer from 7.2% (pancreas) to 89.6% (prostate) in men, and from 10.0% (pancreas) to 93.1% (thyroid) in women in the last period. Survival declined with age, showing different patterns by cancer. Between both periods, age-standardized five-year net survival increased overall by 3.3% (95% CI 3.0-3.7%) in men and 2.5% (95% CI 2.0-3.0%) in women, and for most cancer groups. Improvements were greater in patients younger than 75 years than in older patients. Chronic myeloid leukemia and myeloma showed the largest increases. Among the most common malignancies, the greatest absolute increases in survival were observed for colon (5.0%, 95% CI 4.0-6.0%) and rectal cancers (4.5%, 95% CI 3.2-5.9%). Survival improved even for some cancers with poor prognosis (pancreas, esophagus, lung, liver, and brain cancer). Further investigation of possible sociodemographic inequalities is warranted. This study contributes to the evaluation of cancer control and health services' effectiveness.

Prostate Cancer Survival by Risk and Other Prognostic Factors in Mallorca, Spain.

Studies about the survival of patients with prostate cancer by stage or risk of progression are scarce. The aims of this study were (1) to determine the cause-specific survival by risk in prostate cancer patients in Mallorca diagnosed in the period 2006-2011; (2) to identify the factors that explain and predict the likelihood of survival and the risk of dying from this type of cancer; and (3) to determine the distribution of prostate cancer by risk in the patients in Mallorca diagnosed in the period 2006-2011. Incident prostate cancer cases diagnosed between 2006 and 2011 were identified through the Mallorca Cancer Registry. We collected age; date and method of diagnosis; date of follow-up or death; T, N, M and stage according to the TNM 7th edition; Gleason score; prostate-specific antigen (PSA); histology according to the International Classification of Diseases for Oncology (ICD-O) 3rd edition, comorbidities and treatments. We calculated risk in four categories: low, medium, high and very high. The end point of follow-up was 31 December 2014. Multiple imputation (MI) was performed to estimate cases with unknown risk. We identified 2921 cases. Five years after diagnosis, survival after MI was 89% globally, and was 100% for low-risk cases, 96% for medium risk, 93% for high risk and 69% for very-high-risk cases. Cases with histology other than adenocarcinoma, with high (and especially very high) risk, as well as with systemic, mixed and observation/unspecified treatments had worse prognoses.

Supervivencia por estadio del cáncer de cuello uterino en Mallorca y factores asociados recogidos por el Registro de Cáncer / Survival by cervical cancer stage and factors collected by the Cancer Registry in Mallorca (Spain)

OBJETIVO: Determinar la supervivencia por estadio del cáncer cervical en Mallorca, identificar los factores recogidos por el Registro de Cáncer de Mallorca asociados a la supervivencia y conocer la distribución de los casos por estadios. MÉTODO: Estudio retrospectivo de casos diagnosticados con cáncer cervical entre 2006 y 2012 a través del Registro de Cáncer de Mallorca. Se excluyeron los casos identificados solo por certificado de defunción. Variables: edad, fecha y método de diagnóstico, histología (ICD-O 3.ª ed.); TNM y etapa (UICC 7.ª ed.), fecha de seguimiento o muerte, y causa de muerte. El seguimiento finalizó el 31 de diciembre de 2015. Se aplicó la imputación múltiple para los casos cuyo estadio era desconocido. Se utilizaron los métodos actuarial y de Kaplan-Meier para el análisis de la supervivencia, y la regresión de Cox para identificar los factores que explican y predicen la supervivencia. RESULTADOS: Se identificaron 321 casos. En el 8,4% se desconocía el estadio. Después de la imputación múltiple, el 42,63% estaban en estadio I, el 24,01% en estadio II, el 19,94% en estadio III y el 13,42% en estadio IV. La supervivencia fue del 63% a los 5 años: 92% para el estadio I, 59% para el estadio II, 37% para el estadio III y 18% para el estadio IV. El estadio y la edad fueron los factores asociados a la supervivencia. CONCLUSIONES: El diagnóstico de cáncer de cuello uterino en estadio I es esencial. Menos de la mitad de las mujeres fueron diagnosticadas en estadio I. Es necesario mejorar los programas de cribado del cáncer de cuello uterino

OBJECTIVE: To ascertain the survival by stage of cervical cancer in Mallorca (Spain), to explore factors collected by the Mallorcan Cancer Registry associated with survival, and to determine the distribution of cervical cases by stage. METHOD: Retrospective follow-up study of cases diagnosed with cervical cancer between 2006 and 2012 through the Mallorcan Cancer Registry. Cases identified only by death certificate were excluded. Variables: age; date and method of diagnosis; histology (ICD-O 3rd ed.); TNM and stage (UICC 7th ed.); date of follow-up or death and cause of death. Follow-up ended on 31 of December 2015. Multiple imputation was used for missing stage cases. Actuarial and Kaplan-Meier methods were used for survival analysis and Cox regression models to identify factors that explain and predict survival. RESULTS: 321 cases were identified. The stage was missing in 8.4% of cases. After multiple imputation, 42.63% were stage I, 24.01% stage II, 19.94% stage III and 13.42% stage IV. Survival was 63% at 5 years: 92% for women diagnosed in stage I, 59% in stage II, 37% in stage III and 18% in stage IV. Stage and age were associated to survival. CONCLUSIONS: Diagnosis of cervical cancer in stage I is essential. Less than half of the women were diagnosed in stage I. Cervical cancer screening programmes must be improved

[Survival by cervical cancer stage and factors collected by the Cancer Registry in Mallorca (Spain)]. / Supervivencia por estadio del cáncer de cuello uterino en Mallorca y factores asociados recogidos por el Registro de Cáncer.

OBJECTIVE: To ascertain the survival by stage of cervical cancer in Mallorca (Spain), to explore factors collected by the Mallorcan Cancer Registry associated with survival, and to determine the distribution of cervical cases by stage. METHOD: Retrospective follow-up study of cases diagnosed with cervical cancer between 2006 and 2012 through the Mallorcan Cancer Registry. Cases identified only by death certificate were excluded. VARIABLES: age; date and method of diagnosis; histology (ICD-O 3rd ed.); TNM and stage (UICC 7th ed.); date of follow-up or death and cause of death. Follow-up ended on 31 of December 2015. Multiple imputation was used for missing stage cases. Actuarial and Kaplan-Meier methods were used for survival analysis and Cox regression models to identify factors that explain and predict survival. RESULTS: 321 cases were identified. The stage was missing in 8.4% of cases. After multiple imputation, 42.63% were stage I, 24.01% stage II, 19.94% stage III and 13.42% stage IV. Survival was 63% at 5 years: 92% for women diagnosed in stage I, 59% in stage II, 37% in stage III and 18% in stage IV. Stage and age were associated to survival. CONCLUSIONS: Diagnosis of cervical cancer in stage I is essential. Less than half of the women were diagnosed in stage I. Cervical cancer screening programmes must be improved.