September is a month dedicated to childhood cancers. Update on the epidemiology of pediatric tumors, their origins and progress in their treatment, with Professor Véronique Minard-Colin, pediatrician-oncologist at the Gustave-Roussy Institute (IGR) in Villejuif (Val-de-Marne). ).
What do childhood cancers represent, epidemiologically?
They form about 1% of all cancers. In France, 2,100 to 2,200 children and adolescents are affected each year – ie one child in 500 to 600. And more than one child or adolescent dies of cancer every day, ie approximately 500 deaths per year. Between the ages of 1 and 15, cancers are the second leading cause of death after accidents.
France has set up a National Registry of Childhood Cancers (RNCE), which lists all children and adolescents affected, since 1990 for blood tumors, and 2000 for solid tumors. Since 2011, this register has been extended to the West Indies, Guyana and Reunion. The latest published study shows no significant increase in the number of childhood cancers between 2000 and 2014. The analysis of the data was continued until 2018: still unpublished, it confirms this trend towards stability – except perhaps be a slight increase in brain tumours, but their mode of classification and the diagnostic tools changed between the beginning and the end of the follow-up.
What are the specificities of childhood cancers?
A child is a developing being, his organs and his immune system are immature. This is why it is more affected by certain cancers. The adult develops many carcinomas, which affect tissues lining the external or internal surfaces of the body (skin, mucous membranes). But, in children aged 0 to 14, nearly a quarter of cancers are embryonic tumors, which most often spare adults. The cancerous cells, which grow very quickly, look like embryonic cells here. Many tissues can be affected: sympathetic (neuroblastoma) or central (medulloblastoma) nervous system, kidney (nephroblastoma), retina (retinoblastoma)…
In children aged 0 to 14, 29% of cancers are leukemia. In 80% of cases, it is acute lymphoblastic leukemia – adults, more often, have myeloid leukemia. Next come central nervous system tumors (25% of cases) and sarcomas (11%), tumors that affect the supporting tissues of bones, muscles, adipose tissue, etc. Lymphomas represent 10% of cases.
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