Abstract
Background: Childhood cancer is considered one the most important causes of death in children and adolescents, despite having a low incidence in this population. Spatial analysis has been previously used for the study of childhood cancer to study the geographical distribution of leukemias. This study aimed to identify the presence of space-time clusters of childhood of cancer excluding leukemia in Colombia between 2014 and 2017. Methods: All incident cancer cases (excluding leukemia) in children under the age of 15 years that had been confirmed by the National Surveillance System of Childhood Cancer between 2014 and 2017 were included. Kulldorf's circular scan test was used to identify clusters using the municipality of residence as the spatial unit of analysis and the year of diagnosis as the temporal unit of analysis. A sensitivity analysis was conducted with different upper limit parameters for the at-risk population. Results: A total of 2006 cases of non-leukemia childhood cancer were analyzed, distributed in 432 municipalities with a mean annual incidence rate of 44 cases per million children under the age of 15. Central nervous system (CNS) tumors were the most frequent type. Four spatial clusters and two space-time clusters were identified in the central and southwest regions of the country. In the analysis for CNS tumors, a spatial cluster was identified in the central region of the country. Conclusions: The distribution of non-leukemia childhood cancer seems to have a clustered distribution in some Colombian regions that may suggest infectious or environmental factors associated with its incidence.
Highlights
Childhood cancer (CC) is considered one the most important causes of death in children and adolescents, despite having a low incidence in this population
For the analysis of Central nervous system (CNS) tumors those who were included in the ICCC-3 classification group III were selected, obtaining 603 cases reported in 201 municipalities (17.9%)
The mean annual incidence rate of non-leukemia CC was of 44 cases per million children under 15 years of age between 2014 and 2017 in Colombia
Summary
Childhood cancer (CC) is considered one the most important causes of death in children and adolescents, despite having a low incidence in this population. There are several conditions that have been identified as risk factors which include genetic factors, some infectious diseases, exposure to pesticides, benzene and radiation, alcohol consumption during pregnancy, smoking, and the socioeconomic condition of the family[4,5]. Results: A total of 2006 cases of non-leukemia childhood cancer were analyzed, distributed in 432 municipalities with a mean annual incidence rate of 44 cases per million children under the age of 15. Conclusions: The distribution of non-leukemia childhood cancer seems to have a clustered distribution in some Colombian regions that may suggest infectious or environmental factors associated with its incidence
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