Incidence and survival cancer trends in children and adolescents in the provinces of Florence and Prato (Central Italy), 1985-1997

Aims and background: The incidence of childhood and adolescent cancers has been increasing during the last decades in most Western countries. Improvements in cancer survival rates have also been observed according to the availability of more efficient therapies. Methods and study design: A total of 518 cancer cases (age, 0-19 years) incident in the period 1985-1997 in the Tuscany Cancer Registry area, corresponding to the Provinces of Florence and Prato (Central Italy), were analyzed. Incidence rates and estimated annual percentage change were computed according to sex, 5-year age groups and diagnostic groups of the International Classification for Childhood Cancer. All patients were actively followed at 31.12.1998, and 5-year survival rates were computed for cases diagnosed in 1985-1990 and 1991-1997. Results: Overall age-standardized incidence rates were 186.7/10(6) for males and 175.4 for females. In 1991-1997, standardized incident rates were 50.8 for leukemias, 44.6 for lymphomas, and 34.3 for CNS tumors. There was a marked increasing trend for lymphomas that grew at a yearly rate of +12.1% and less evident increasing tendency for leukemias, CNS tumors and carcinomas. The overall survival rate was 88% at one year, 78% at 3 years, and 74% at 5 years. A slight improving tendency in survival was evident over time. Conclusions: The study pointed out that in the examined area, during 1985-1997, there was a significant increasing incidence trend for lymphomas. Survival rates were as high as in other Western countries - evidence of the high level of diagnostic and treatment services in the area.