Childhood and adolescent lymphoma in Spain: incidence and survival trends over 20 years

Background: Lymphoma is the third most common malignancy in children (0-14 years) and the first in adolescents (15-19 years). This population-based study-the largest ever done in Spain-analyses incidence and survival of lymphomas among Spanish children and adolescents. Patients and methods 1664 lymphoma cases (1983-2007) for incidence and 1030 for survival (1991-2005) followed until 31/12/2010, were provided by 11 cancer registries. Age-adjusted incidence rates (ASRw) to the world standard population were obtained; incidence trends were modelled using the Joinpoint programme, observed survival (OS) was estimated with Kaplan-Meier and trends tested with a log-rank test. Results are presented according to the International Classification of Childhood Cancer-3. Results: In Spain, the ASRw0-14 for lymphomas was 17.5 per 1.000.000 child-years and 50.0 the specific rate for adolescents. Overall incidence increased significantly during 1983-1997 with no increases thereafter. Patients over 9 years old showed significant rising trends for all subtypes, except for Burkitt lymphoma (BL) in adolescents. During 2001-2005 (age 0-19 years), 5-year OS was 94 (90-98), 73 (64-83) and 86 (78-94) for Hodgkin lymphoma (HL), non-Hodgkin lymphoma (NHL) and BL, respectively. No improvement in survival was found. The incidence in Spain was higher than overall European rates, but within the range of that in Southern Europe. Comparing OS in Spain 1991-1995 and 2001-2005 with results for Europe of the Automated Childhood Cancer Information System (ACCIS) (1988-1997) and the European cancer registry-based study on survival and care of cancer patients (EUROCARE) (2000-2007), it was similar for HL and lower for NHL and BL. Conclusions: Systematic monitoring and analysis of lymphoma paediatric data would provide clinical and epidemiological information to improve the health care of these patients and the outcomes for these malignancies in Spain

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Incidence and survival time trends for Spanish children and adolescents with leukaemia from 1983 to 2007

Objective. We have analysed incidence and survival trends of children and adolescents with leukaemia registered in Spanish population-based cancer registries during the period 1983-2007. Methods. Childhood and adolescent leukaemia cases were drawn from the 11 Spanish population-based cancer registries. For survival, registries with data for the period 1991-2005 and follow-up until 31-12-2010 were included. Overall incidence trends were evaluated using joinpoint analysis. Observed survival rates were estimated using Kaplan-Meier, and trends were tested using the log-rank test. Results. Based on 2606 cases (2274 children and 332 adolescents), the overall age-adjusted incidence rate (ASRw) of leukaemia was 47.9 cases per million child-years in children and 23.8 in adolescents. The ASRw of leukaemia increased with an annual percentage change of 9.6 % (95 % CI: 2.2-17.6) until 1990 followed by a stabilisation of rates. In adolescents, incidence did not increase. Five-year survival increased from 66 % in 1991-1995 to 76 % in 2001-2005. By age, survival was dramatically lower in infants (0) and adolescents (15−19) than in the other age groups and no improvement was observed. In both children and adolescents, differences in 5-year survival rates among major subgroups of leukaemias were significant. Conclusions. The increasing incidence trends observed in childhood leukaemias during the study period were confined to the beginning of the period. Remarkable improvements in survival have been observed in Spanish children with leukaemias. However, this improvement was not observed in infants and adolescents (AU)

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Duración de la incapacidad temporal por tuberculosis / Length of time off work due to tuberculosis

Objetivo. Determinar la duración media de la incapacidad temporal (IT) en los enfermos tuberculosos laboralmente activos de un área de salud. Diseño. Descriptivo, retrospectivo. Emplazamiento. Nivel comunitario de un área de salud. Participantes. Personas diagnosticadas de tuberculosis entre 1989 y 1998 que han causado incapacidad temporal. Mediciones y resultados principales. Se cruzó una base de datos epidemiológicos de enfermos tuberculosos con los registros de IT de la inspección médica del área, obteniéndose un total de 58 pacientes. Se registró una duración media de la IT de 220,3 días. La edad media fue de 37 años, con gran predominio de varones (93,1 por ciento). Un porcentaje considerable de los trabajadores (36,2 por ciento) corresponde a mineros, que tienen una duración de la IT superior al resto de los trabajadores (p=0,003). Para las variables edad, sexo, zona básica de salud, tipo de tuberculosis y año del diagnóstico no se encontraron diferencias significativas en la duración de la IT. Conclusiones. Detectamos una duración de la IT mucho más prolongada que los estándares habituales, y en relación con la penosidad del trabajo físico. Debería plantearse la vuelta al trabajo cuando exista una mejoría clínica del paciente y una seguridad de respuesta al tratamiento antituberculoso (AU)