Changing geographical patterns and trends in cancer incidence in children and adolescents in Europe, 1991–2010 (Automated Childhood Cancer Information System): a population-based study

Background: A deceleration in the increase in cancer incidence in children and adolescents has been reported in several national and regional studies in Europe. Based on a large database representing 1·3 billion person-years over the period 1991–2010, we provide a consolidated report on cancer incidence trends at ages 0–19 years. Methods: We invited all population-based cancer registries operating in European countries to participate in this population-based registry study. We requested a listing of individual records of cancer cases, including sex, age, date of birth, date of cancer diagnosis, tumour sequence number, primary site, morphology, behaviour, and the most valid basis of diagnosis. We also requested population counts in each calendar year by sex and age for the registration area, from official national sources, and specific information about the covered area and registration practices. An eligible registry could become a contributor if it provided quality data for all complete calendar years in the period 1991–2010. Incidence rates and the average annual percentage change with 95% CIs were reported for all cancers and major diagnostic groups, by region and overall, separately for children (age 0–14 years) and adolescents (age 15–19 years). We examined and quantified the stability of the trends with joinpoint analyses. Findings: For the years 1991–2010, 53 registries in 19 countries contributed a total of 180 335 unique cases. We excluded 15 162 (8·4%) of 180 335 cases due to differing practices of registration, and considered the quality indicators for the 165 173 cases included to be satisfactory. The average annual age-standardised incidence was 137·5 (95% CI 136·7–138·3) per million person-years and incidence increased significantly by 0·54% (0·44–0·65) per year in children (age 0–14 years) with no change in trend. In adolescents, the combined European incidence was 176·2 (174·4–178·0) per million person-years based on all 35 138 eligible cases and increased significantly by 0·96% (0·73–1·19) per year, although recent changes in rates among adolescents suggest a deceleration in this increasing trend. We observed temporal variations in trends by age group, geographical region, and diagnostic group. The combined age-standardised incidence of leukaemia based on 48 458 cases in children was 46·9 (46·5–47·3) per million person-years and increased significantly by 0·66% (0·48–0·84) per year. The average overall incidence of leukaemia in adolescents was 23·6 (22·9–24·3) per million person-years, based on 4702 cases, and the average annual change was 0·93% (0·49–1·37). We also observed increasing incidence of lymphoma in adolescents (average annual change 1·04% [0·65–1·44], malignant CNS tumours in children (average annual change 0·49% [0·20–0·77]), and other tumours in both children (average annual change 0·56 [0·40–0·72]) and adolescents (average annual change 1·17 [0·82–1·53]). Interpretation: Improvements in the diagnosis and registration of cancers over time could partly explain the observed increase in incidence, although some changes in underlying putative risk factors cannot be excluded. Cancer incidence trends in this young population require continued monitoring at an international level. Funding: Federal Ministry of Health of the Federal German Government, the European Union's Seventh Framework Programme, and International Agency for Research on Cancer

Identification of hepatitis C virus (HCV) genotypes in infected patients from the west of Mexico

Information about genotypes and associated risk factors in hepatitis C virus (HCV) infected patients in Latin America is limited. The aim of this study was to identify the HCV genotypes and associated risk factors in a group of HCV infected patients from the west of Mexico. Genotyping analysis was performed in 90 patients with positive anti-HCV and HCV-RNA. Genotypes 1 and 2 were found in 61 (67.8%) and 28 (31.1%) patients, respectively, and one with 4c/d genotype (1.1%). The most frequent HCV genotype was la (42.2%), followed by 1b (21.1%) and 2a/c (20%). Coinfection was present in 6.6% in a similar population with genotypes 1a and 1b or with 2a/c and 2b. The most frequent associated risk factor was blood transfusion in 57.8% of cases. However, there was no statistically significant difference between the risk factors analyzed and the acquisition of HCV infection

Identification of hepatitis C virus (HCV) genotypes in infected patients from the west of Mexico

Information about genotypes and associated risk factors in hepatitis C virus (HCV) infected patients in Latin America is limited. The aim of this study was to identify the HCV genotypes and associated risk factors in a group of HCV infected patients from the west of Mexico. Genotyping analysis was performed in 90 patients with positive anti-HCV and HCV-RNA. Genotypes 1 and 2 were found in 61 (67.8%) and 28 (31.1%) patients, respectively, and one with 4c/d genotype (1.1%). The most frequent HCV genotype was la (42.2%), followed by 1b (21.1%) and 2a/c (20%). Coinfection was present in 6.6% in a similar population with genotypes 1a and 1b or with 2a/c and 2b. The most frequent associated risk factor was blood transfusion in 57.8% of cases. However, there was no statistically significant difference between the risk factors analyzed and the acquisition of HCV infection