Clustering of non-leukemia childhood cancer in Colombia: a nationwide study

F1000Res. 2021 Feb 9:10:86. doi: 10.12688/f1000research.27766.2. eCollection 2021.

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 in the clusters. Results: A total of 2006 cases of non-leukemia childhood cancer were analyzed, distributed in 432 out of 1,122 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. 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 although heterogeneity in access to diagnosis cannot be discarded.

Keywords: Childhood; Cluster Analysis; Colombia; Epidemiology; Neoplasms.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Cities
  • Cluster Analysis
  • Colombia / epidemiology
  • Humans
  • Leukemia* / epidemiology
  • Neoplasms* / epidemiology

Grants and funding

This work was supported by the Colombian Ministry of Science and Technology - MINCIENCIAS- Grant No. 789-2017 and Grant No. 899-2019. The funder did not have any role in the design, analysis, or interpretation of the study.