RESEARCH BRIEF

Chi
ldhoodCancerIn
cid
enc
einInd
ia:AR
evi
ewo
fPopu
lat
ion
-Ba
sed
Cance
rR e
gis
tri
es
LSATYANARAYANA,S
MITHA A
STHANAAND *P I L
REET IS
ABAN
Fr
omtheDivis
ionofEpid
em io
logyandB ios
tat
is
tics
,In
st
itut
eofCy
tologyandPre
ven
tiv
eOn co
logy
,NOIDAand
*Dep
artme
n tofPed
iat
ric
s,LNH osp
ita
l,N ewD e
lhi
,In
dia.
Co
rre
spondenceto
:D rSmitaAsthana
,S ci
ent
istC,ICPO(ICMR)
,Sec-39
,NO IDA201301
,India
.smi
tasan
jay97@
yahoo
.com

Objec
tives
:T o summa rize and p
rovide an o
ver
view o
fthe permil
lionto159.6pe rmi
ll
ionforboysand11.3to112
.4forgi
rls.
ch
ildhood cancerincidencereportedin 25 popu
lat
ion
-based The highe s
t in c
idence was ob se
rvedfor males(159.6
)in
cancerreg
ist
riesofIndia
. Southernregionofthecoun t
ryandthelowe stin No
rth
-eastin
bothbo ys(18.6
)andg ir
ls(11
.3)
.Leu kemiaandlymphomawe re
Methods: Se condary data on age
-adjus
tedratesof cancer thecommone s
t malignanc
iesin bo y
s whereasleukemia and
incidence
forch i
ldren(0-14years
)we reco
l
le c
ted
fromtherepor
t bra
intumo rswerecommone st
ingirl
s.
o
fthe Na t
ional Cancer Regis
tryProgrammeintheyear2013 .
rangeo fage-ad
justed-ra
te spermi
ll
ionchi
ldren we
retabu
lated Conc
lus
ion: Ch
ildhood cance
rind
ic
idence appea
rsto be
forsixreg
ionsofthecoun tr
y. inc
reas
ing
inInd
ia.

Resu
lts
: Age
-ad
jus
tedcan
cer
inc
iden
cera
tesrangedf
rom18
.6 Keywo
rds:
Can
cers
tat
is
ti
cs,Neop
lasm
,Ped
iat
riccan
cer.

C
an ce
rinch i
ldrenandado les
c en
tsisr a
reand containingd atasu cha sin c
id enc er atesand mo rtali
ty
biologi
cal
ly v ery dif
ferentf romc ancerin rateso fc ancera tth epopu lation lev elar ebrough tou tby
adults[1]
.I tise s
tim a
tedth atabout148000 NCRP . Th e
ser epo rtsd e
sc r
ib eth em ethodso fd ata
can ce
rsoccurredduring2008 inchild
renag ed collec
tionandqu alitycon trolm e asur es
.In it
ially,th e
r e
0–14y e
ar sinl ess
-deve
lop edregions[2]
.InInd iacancer weres ix PBCR sinth e NCRP ’sn etwo rk,andth ese
isthe9thcommonc auseforth ed ea
thsamongch ild
ren cov e
redon ly3%o fth ecoun t
ry ’spopu la
tion.L atest
between5to14y ea
rso fag e[3]. Thep ropo
rtiono f NCRPr epor
t(2013 )[4 ]p rovid esd ataf rom25PBCR s
chi
ldhoodc ancer
sr e
lativetoa llc ancersreportedby cov e
ring7 .45%o fth ecoun try’spopu lation.Th ed a
taon
Indi
anc anc erregis
tr
iesv a
riedfrom0 .8%to5 .8%in CCIint ermso fag e-adjus
t ed-rate(AAR )p e
rm ill
ion
boys
,a ndfr om0 .5%to3 .4% ingi
rls[4]
. childreno fei
th ers exfo rallsitescomb ined iny ear s2006
to201 1in25PBCR sw e r
eu sedfo rsumm ar
ized.Th e25
W
ee ar
lierreport
edt rendsinch ildhoodc ancerri
sk
PBCR sd a
taw eresumm arizedind iffer entreg ion sa s
basedonin c
iden c
eforth ey e
ar s1982-2000inInd i
an
follow s
: No rth: D elhi
;Sou th:B ang a
lo re
, Ch ennai,
sta
tes[5 ]
. Th e
r earef ews tudiesr epor
tingch i
ldhood
KollamandT i ruvan anthapu ram ;C entra l:Bhop al;E as
t:
cancerincidence(CC I
)f romc an cerregi
stri
esinInd i
an
Kolkata; No rth- east: C ach ar, D ibrug a
rh, K am rup,
sta
tes[6-11].Anupd atedov erviewo fch i
ldhoodc ancer
Manipur, M izo ramand S ikk im , M egh alaya,T ripu ra
,
incidenced ataw il
lb eo fh elpfo rr esearch
ers’and
Nag a
land ;W est: Mumb a
i,N agpur, Pun e
, Ahm adab ad
cl
inicians for quick r efe
renc eo ff ac
ts in c ance
r
(urban )andB arshi( extend ed),Au rang ab ad
,W ardh aand
contro
l.Th i
sr eportat
temp tstop rovidether eaderan
RuralW es
t: B arshi( rur a
l)and Ahm edab ad(ru ra l
).Th e
updatedsumm a
r yove
rviewo fthe inciden
ceo fchi
ldhood
groupingo fregistrie sasr egion sw erep resentedbyth e
canceronth eb as
isofth e2013r epor
tf rom N a
tiona
l
authorsfo rth epupo seo fstudyu singth elo cat
iono fth e
CancerR egist
ryP rogr
am(NCRP )fo rthey ear
s2006 -
regis
tr y
.Itw asn ot therei ntheNCRP re port.
2011th a
tcov ered25popu lat
ion -basedcan c
erregis
trie
s
(PBCR )
inI ndi
a. Forbo
thboy sandgi
rls
,CCIsa
sAAR sfor10s el
ected
METHODS broadtypeso f chi
ldhood c
ance
rs[C en
tral-ne
rvous-
sys
t em(CNS )tumours
,SNStumou r
s,r e
tinoblas
tom a
,
Th
eInd
ianCoun
cilofMed
ica
lRese
arch(ICMR)s
tar
ted renaltumour
,h ept
ictumour
,bonetumou r,softtis
sue
th
eNCRPw i
thanetwo
rkofc
anc
erreg
ist
rie
sac
ros
sI n
dia sar
com as
, g e
rmc e
ll tumours
, l eukemi a
s and
in De
cembe
r 1981. Comp
reh
ensiv
e annua
lr epor
ts lym phomas
].

I
NDIAN P
EDIATR
ICS 218 VOLUME 5
1__MARCH 15
,2014
SATYANARAYANA,
eta
l. CANCER IIDENCEINI
NC NDIA

RESULTS
Tab
leI presen
tsda
taonCC Ipresen
tedasAAR sf
rom the
25PBCR sandar
rangedasper
thelocat
ionof
theregis
try
.
Tab
leI Id ep
ic
tsm inimuma ndm aximum AAR p e
r
mi
ll
iono f CCIinbro adtypesforsix majo
rc ancer
reg
ist
rie
s(D e
lhi
, Mumb a
i,Chennai
,Banga
lore
,Ko lka
ta,
Ahmedabadurb
an)
.
F
ig.1p re
s en
tsinciden
ceof10 m ajorchi
ldhood
c
anc
ersfor6regi
str
iesinboysandgi
rls,respec
tiv
ely
.
L
eukemi
asw asthe mostcommon m
alignancyinboth L
euke
-Lym- CNS SNS R
etino Hepa
ticB
one S
oft G
erm
m
ia p
homatum
ortum
orb
lastomat
umor T
umorT
issu
e Cel
l
s
exe
s. t
um o
r S
arcomaT
umor

DISCUSSION (a
)

Th
isa
rt
icl
esumm
ari
zes ch
ildhood c
anc
erin
cid
enc
e

TABLEI CH
ILDHOOD CANCER IIDENCEINI
NC IAFORTHE Y
ND EAR
20
0 6
-2011ACCORDINGTOTHE LOCAIONOF R
T EGISTRY

R
egi
str
ylo
cat
ion* Can
cerInc
idenceAARpm(%ofcance
rsin
ch
ildho
odo u
tofa
llc
ancers
)
Bo
ys G
ir
ls
L
euke
-Lym- CNS SNS R
etino Hepa
ticB
one S
oft G
erm
No
rth 149
.4(5
.8) 77
.7(2
.8) m
ia p
homatum
ortum
orb
lastomat
umor T
umorT
issu
e Cel
l
Sou
th 91
.6-159
.6(1
.7-3
.1) 69
.9-1
12.4(1
.4-2
.0) t
um o
r S
arcomaT
umor

C
ent
ral 7
0.7(
3.3
) 6
1.9(
2.5
) (b
)

E
ast
/no
rth
-ea
st 18
.6-1
11.1(0
.8-2
.9) 1
1.3
-69
.3(0
.5-2
.5) FIG.1C
hil
dhoodca
nceri
ncid
ence
forbroa
dC an
cer
-ty
pes
ins
ele
cte
d
r
egis
tr
iesamon
gb o
ys(a)andg
ir
ls(b)
.
W
est 32
.9-1
17.4(2
.2-4
.2) 18
.0-84
.6(1
.3-1
.9)
R
ura
lwe
st 6
0.7
-72
.8(
3.5
-4.
7) 3
8.7
-51
.0(
2.2
-3.
4)
A
llr
egion
s 18
.6-159
.6(0
.8-5
.8) 1
1.3
-112
.4(0
.5-3
.4) repor
tedby NCRP. Thehighes
tCC Iw a
sob se
rvedfor
AARpm
:Age-a
djus
tedrat
esofi
nci
den
cep
erm
il
lio
n;D
atas
our
ce: mal
esinSouth
ernreg
ionofthecoun
tryandthelowes
tin
NCRPr
epo
rt2009–201
1[4]
. Nor
theas
tinbothboy
sandgirl
s.Leukemia
s,lymphomas
andCNS t
um our
sw e
reth
em ostcomm o
nm ali
gnanc
ies
.
TABLEI
ICH ILDHOOD CANCER IIDENCE IN B
NC ROAD C
ANCER Ane ar
lierrevi ew[7 ]r epo rtedchildhoodc an c
er sto
TYPESFOR S
IX MAJOR R
EGISTR
IES cont
ribute1.6to4 .8%o fallc an ce
rs(CC Ia s38 to124p er
T
umo
rtyp
einCh
ildhood AARp
erm
il
lion
mi
ll
ion )inInd iafo rth ey ears 2001-2004 . Th erei s
apparentincreasein m agn itud eof CC Iov e rp er
iodo f
(
0-1
4ye
ars
) B
oys G
ir
ls seveny ea
r s
.Th edifferen cesinp roport
ionandm agnitud e
L
euk
emi
a 35
.7-61
.3 22
.3-40
.2
ofCC Iamongd ifferentr egion sinIndi acouldb edu eto
var
iou scomp lianc etoc an c
err egist
r a
tiona sw e
l la s
L
ymp
hom
a 9
.9-25
.6 2
.9-10
.1
geographica
la ndg en d
erv aria
tio n
s.A ne ar
lierrep o
rt[ 12]
C
ent
ral
-ne
rvo
us-
sys
tem
tum
or 6
.6-19
.8 3
.0-16
.0 sta
tedth a
ttheg end er
-differ encesinth echildhoodc ancer
SNS
tum
or 1
.5-12
.6 1
.8-5
.3 regi
strat
ionind evelopingcoun tr
iesex istandsugg ested
R
et
ino
bla
stom
a 1
.9-12
.3 1
.3-6
.7 that interna
tion a
ld iffer ences in th e in c
id enceo f
R
ena
ltum
or 3
.1-9
.5 1
.8-7
.0 chi
ldhoodc ancershou ldb einterpretedc aut
iou s
lya sth ey
H
epa
ti
ctum
or 0
.5-2
.0 1
.0-1
.8 mayno tnecessa
rilyr ef
l ectn a
tu ra
ldi f
feren c
e s
.Ar ecent
rev
i ewsugg estedth atsom eo fth e
s edifferencesm ight
Bon
etumo
r 2
.8-9
.0 2
.3-6
.2
or
iginatefromexpo suresdu ringp renatald ev e
lopm ent
S
oft
tis
sueS
arc
oma 2
.8-7
.2 1
.6-7
.6
[13]
.I nlow-a ndm id d
le-in com ec ountries
,w her
e8 0%o f
G
ermc
el
ltum
or 1
.3-12
.9 0
.2-1
.3 chi
ldren l ive, th e 200 ,000 ch i
ld ren d iagno sed
AAR:Ag
e-ad
jus
tedra
tes
;Sou
rce
:NCRPr
epo
rt2009–201
1[4
]. wi
thc ancereachy earh av elim it
eda ccesstocu rative

I
NDIAN P
EDIATR
ICS 219 VOLUME 5
1__MARCH 15
,2014
SATYANARAYANA,
eta
l. CANCER IIDENCEINI
NC NDIA

trea
tm ent
, and on
ly about 25% su rv
ive[14]. The PBCR_2009_2011 .aspx .A cces sed24 thS eptemb e
r2013 .
di
ffe
ren ce in survival fo r chi
ldren diagnosed 5
.S aty an arayan aL ,A sth an aS. Ch ildhoodc an c
erriskt rend s
wi
thcan ce
rbetween high andlow -
income coun
tri
e s inInd ia(1982 -2000 ).Ind ianP ed iatr.2007 ;44:939 -41 .
cont
inu e
stowidenascura
tivethe
rapi
esaredeve
lopedin 6
.D att a K , Choudhu ri M , Guh a S , B isw as J .
Childhoodc an ce rbu rd en in p art o f e asternInd i a-
theformerbutno
tim p
leme n
tedinth
elat
ter[
15]
.
Popu lationB as edC an c erR egistryd atafo rKo lkata(1997 -
Incon c
lus
ion
,thestudyobse
rvedag
ene
ralin
crea
se 2004 ).A siaP acJC an cerP rev.2010 ;11:1283 -8.
7
.A ro raRS ,Ed enTO ,K apoo rG .Ep id em iologyo fch i
ldhood
inchildhoodcan
cerinc
idence
;highe
rin
cid
enceiss
een
can cer inInd ia.Ind i anJC an cer.2009 ;46 :264 -73.
amo n
gb oysofSou
ther
nregio
n. 8
.Sw am in a
th anR ,R am aR ,Sh antaV .Ch ildhoodc ancers in
Cont
ribut
ors
: LSa n
dSA :stud
ydesig
n,p
lann
ing,
int
erpr
eta
tion Chenn ai,Ind i a
, 1990 -2001 :in cid en ceandsu rviv a
l.In t
andan a
lys
isdata
;PLS:inte
rpre
tat
ionofda
taandinte
lle
ctu
al JC anc er.2008 ;122 :2607 -11.
inputs
. 9
.Y eo leBB ,Ku rku reAP ,Koy and eSS .G eog raphicv ar
i at
ion
Funding:none
;Comp
etin
g i
nter
est
s:Non es
tat
ed. inc anc erin cid en ceandi tsp attern sinu rb an M ah ar
a shtra
,
2001 .A sianP a cJC an c e
rP rev.2006 ;7:385 -90.
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,2014