Cyprus has world-high child cancer rates

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A pioneering study showed that Cyprus has among the world’s highest incidence rates for cancer in children with leukaemias, the most frequent.

Cancer in children and adolescents epidemiology was never before examined, so a paediatric oncology registry of Cyprus (PORCY) was created to study the incidence rates in the 0-19 age group.

“We need the information to understand aetiology because only if we understand aetiology can we practice good prevention,” said Dr Loizos Loizou, Clinical Professor of Pediatric Oncology – Hematology at Medical School, University of Nicosia.

He was addressing the 10th International Multi-thematic Scientific Bio-medical Congress in Nicosia.

The study examined incident rates and temporal trends between 0–19-year-olds from 1988-2017.

The PORCY study found that there were 843 cases for this period, with 42 cases as the mean number per year.

It underlined attention on the ASRW (age-standardised rate according to the world standard population), where they found 203, the third highest in the world.

Out of all the cancers in Cyprus, he said, the percentage of childhood cancers is 1.5%, confirming that it is a rare disease.

Dr Loizou underlined the four most frequent cancers in Cyprus are leukaemia, lymphomas, specified epithelial tumours and CNS tumours.

He added that these four groups are present in approximately 73% of all our cases.

He said the distribution per five-year age group, 15–19-year-olds, presents the largest number of cases.

Regarding the incidence trends of the ASRW, there is a relatively stable distribution, except for thyroid cancer, for 15–19-year-olds, involving both sexes.

“This is alarming because, for thyroid cancer in Cyprus, we see that we have again among the world’s highest, there is a very high annual change of 7.5%, which represents almost 10% of all cancer types of this age group with females affected 3-5 times more than males.

“Fortunately, there is a 100% survival rate.”

Dr Loizou said one of the questions is why Cyprus has among the highest incidence rates of childhood cancer worldwide.

“Although it has remained stable throughout the last 20 years, this remains unanswered. The problem exists elsewhere too.”

Professor Loizou said they decided to explore four causes, obesity, ionising radiation, arsenic and cancer predisposition syndromes.

Regarding obesity, he said it has significantly increased in the last 20 years, remarking that in 2015 obesity was affecting 20%, but three years later, that percentage rose to 43%.

For cancer predisposition syndromes, he said these are present in approximately 10% of the cases, and this will be further examined.

“This pioneering study showed that Cyprus has among the world’s highest incidence rates and only Italy and Belgium are higher; there are differences in the most frequent types compared to worldwide patterns.

“Leukaemias are the most frequent cancers; however, lymphomas and thyroid cancers are much more frequent in Cyprus than brain tumours.”

For thyroid cancers, incidence rates in Cyprus are among the highest globally, significantly increasing temporal trends affecting mainly females and adolescents from 15–19-year-olds.

“There are particular patterns in Cyprus that raise aetiology questions, and therefore we should concentrate on exploring the genetic environmental and dietary factors in order to obtain novel insights for better prevention and better cancer control activities.”