INFANT CANCER IN THE US - HISTOLOGY-SPECIFIC INCIDENCE AND TRENDS, 1973 TO 1992

Background: Many cancers in infants demonstrate unique epidemiologic, clinical, and genetic characteristics compared with cancers in older c hildren. Few epidemiologic reports, however, have focused on this impo rtant age group. Methods: Population-based data from the Surveillance, Epidemiology, and End Results (SEER) program were used to estimate re lative frequency, incidence rates, and average annual percentage chang e of rates among children in their first year of life (infants) who we re diagnosed with a malignant neoplasm from 1973 to 1992 (N = 1461). R esults: The greatest proportion of cases (12%) was diagnosed during th e first month of life, with extracranial neuroblastoma accounting for 35% of this total. Overall, the average annual incidence rate was 223/ 1,000,000 infants. Extracranial neuroblastoma was the most common infa nt malignancy (58/1,000,000 infants per year), followed by leukemias ( 37/1,000,000), brain and central nervous system (CNS) tumors (34/1,000 ,000), and retinoblastoma (27/1,000,000). White infants had a 32% high er incidence rate than black infants. The average annual percentage in crease in rates for all cancer from 1973 to 1992 was 2.9% (95% CI: 1.9 %, 3.8%). For neoplasms with at least 100 cases, increasing trends wer e greatest for retinoblastoma (4.6%), CNS (4.1%), and extracranial neu roblastoma (3.4%). Conclusions: Incidence rates increased notably over the study period. Future studies should consider the unique presentat ion of infants with cancer when developing new hypotheses related to c ancer etiology and gene-environment interactions.