Childhood cancers (age at diagnosis: 0-14 years) comprise a variety of malignancies, with incidence varying worldwide by age, sex, ethnicity and geography, that provide insights into cancer etiology. A total of 1,334 childhood cancers registered in populationbased cancer registry, Chennai, India, during 1990-2001 and categorized by International Classification of Childhood Cancer norms formed the study material. Cases included for survival analysis were 1,274 (95.5%). Absolute survival was calculated by actuarial method. Cox proportional hazard model was used to elicit the prognostic factors for survival. The age-standardized rates for all childhood cancers together were 127 per million boys and 88 per million girls. A decreasing trend in incidence rates with increasing 5-year age groups was observed in both sexes. The top 5 childhood cancers were the same among boys and girls: leukemias, lymphomas, central nervous system neoplasms, retinoblastomas and renal tumors. The highest 5-year absolute survival was observed in Hodgkin's disease (65%) followed by Wilm's tumor (64%), retinoblastomas (48%), non-Hodgkin's lymphomas (47%), osteosarcomas (44%), acute lymphoid leukemia and astrocytoma (39%). Multifactorial analysis of age at diagnosis and sex showed no differences in the risk of dying for all childhood cancers. Completeness of treatment and type of hospital combination emerged as a prognostic factor for survival for all childhood cancers together (p < 0.001), acute lymphoid leukemia (p < 0.001) and non-Hodgkin's lymphoma (p 5 0.04). A Childhood Cancer Registry with high-resolution data collection is advocated for in-depth analysis of variation in incidence and survival. ' 2008 Wiley-Liss, Inc.Key words: population-based cancer registry; childhood cancer; incidence; survival; childhood cancer registry The network of cancer registries called National Cancer Registry Program of Indian Council of Medical Research, Government of India, has been in existence since 1981. 1 The Madras Metropolitan Tumor Registry (MMTR), a population-based cancer registry (PBCR), based at the Cancer Institute (WIA), Chennai, collects data on all incident cancer cases occurring in Chennai city and publishes reports on incidence and cancer survival to serve as reference material for oncologists involved in clinical work and research. [2][3][4] Childhood cancers (age at diagnosis 0-14 years) comprise a variety of malignancies, with incidence varying worldwide by age, sex, ethnicity and geography, that provide insights into cancer etiology. 5,6 Publications on childhood cancer incidence and, especially, survival are sparse from India. 7,8 This paper analyses the incidence of and survival from childhood malignancies in Chennai during the period 1990-2001.
Material and methodsCancer is not a notifiable disease in India. Hence, registration of cases is done by active method. 2 The MMTR covers an entirely urban population (all ages) estimated at 4.1 millions in 1996 in the ratio of 960 females to 1,000 males. The corresponding childhood popula...