Children: Head & Neck Rates Up

Head And Neck Cancer Rates Increasing Among US Children

NEW YORK (Reuters Health) Jun 19

Childhood cancer has been on the rise over the past couple of decades in the US and elsewhere, but cancers of the head and neck appear to be outpacing other cancers among American children, according to a new report.

The reasons are unclear and may include factors ranging from better reporting of cases to environmental and prenatal causes, researchers say.

In the current study, researchers analyzed data from the 3050 pediatric head and neck cancers that were reported to the US national cancer registry between 1973 and 1996.

They found that the incidence of these cancers among children younger than 15 years old rose 35% from 1973 to 1975 and from 1994 to 1996, an annual increase from 1.1 cases per 100,000 children to 1.49 cases per 100,000.

This increase compares with a 25% rise in cancer overall for this age group, according to findings published the June issue of the Archives of Otolaryngology Head & Neck Surgery. Dr. James T. Albright, from the Children's Hospital and Health Center in San Diego, California, led the study.

Lymphoma was the most common type of head and neck cancer, affecting 27% of the children in the national database. The next most common cancers included neural tumors, thyroid malignancies and soft tissue sarcomas.

When Dr. Albright's team looked specifically at retinoblastoma rates, they found no increase in the disease over time. The finding that rates of this cancer have remained stable while other head and neck cancer rates have increased suggests that non-genetic factors may be behind the rise in pediatric head and neck cancers.

Well-established environmental factors implicated in pediatric head and neck cancers include exposure to ionizing radiation, excessive sunlight, and certain chemotherapy drugs, the investigators state.

They note that environmental pollution, infection and parental exposure to toxins are suspected, but unproven, contributors. Premature birth and low birth weight have also been associated with a higher-than-average risk of childhood cancer, the report indicates.

The researchers point out, though, that better reporting of childhood head and neck cancers over time might also have contributed to the increase observed.

"Research on a variety of potential carcinogens is ongoing," Dr. Albright's team writes. "Continued surveillance is necessary."

Arch Otolaryngol Head Neck Surg 2002;128:655-659.

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