Objective. To assess the health-related quality of life (HRQL) of 8-to 12-year-old children undergoing therapy for cancer or childhood-cancer survivors by using the Minneapolis-Manchester Quality of Life-Youth Form(MM...Objective. To assess the health-related quality of life (HRQL) of 8-to 12-year-old children undergoing therapy for cancer or childhood-cancer survivors by using the Minneapolis-Manchester Quality of Life-Youth Form(MMQL-YF),a comprehensive,multidimensional self-report instrument with demonstrable reliability and validity. Design,Setting,and Patients. The MMQL-YF consists of 32 items comprising 4 scales:physical functioning,psychologic functioning,physical symptoms,and outlook on life. Scoring on the MMQL ranges from 1 to 5; 5 indicates maximal HRQL. An overall quality-of life (QOL) score is also computed. By using a cross-sectional study design,the MMQL-YF was administered to 90 off-therapy cancer survivors,72 children with cancer undergoing active therapy,and 481 healthy children without a history of cancer or other chronic disease. Results. Compared with healthy controls,children actively undergoing cancer treatment report low overall QOL,physical functioning,and outlook-on-life scores. However,off-therapy survivors report a superior overall QOL,compared with age-matched healthy controls. Conclusions. Young survivors of childhood cancer report a favorable HRQL relative to healthy controls. These results are reassuring,suggesting that this group of survivors may have been too young to encounter some of the negative psychosocial impacts of cancer and its treatment.展开更多
Objective: To test the hypothesis that reduced exposure to common infections in the first year of life increases the risk of developing acute lymphoblastic leukaemia. Design and setting: The United Kingdom childhood c...Objective: To test the hypothesis that reduced exposure to common infections in the first year of life increases the risk of developing acute lymphoblastic leukaemia. Design and setting: The United Kingdom childhood cancer study (UKCCS) is a large population based case-control study of childhood cancer across 10 regions of the UK Participants 6305 children (aged 2-14 years) without cancer; 3140 children with cancer (diagnosed 1991-6), of whom 1286 had acute lymphoblastic leukaemia (ALL). Main outcome measure: Day care and social activity during the first year of life were used as proxies for potential exposure to infection in infancy. Results: Increasing levels of social activity were associated with consistent reductions in risk of ALL; a dose-response trend was seen. When children whose mothers reported no regular activity outside the family were used as the reference group, odds ratios for increasing levels of activity were 0.73 (95%confidence interval 0.62 to 0.87) for any social activity, 0.62 (0.51 to 0.75) for regular day care outside the home, and 0.48 (0.37 to 0.62) for formal day care (attendance at facility with at least four children at least twice a week) (P value for trend < 0.001). Although not as striking, results for non-ALL malignancies showed a similar pattern (P value for trend < 0.001). When children with non-ALL malignancies were taken as the reference group, a significant protective effect for ALL was seen only for formal day care (odds ratio = 0.69, 0.51 to 0.93; P = 0.02). Similar results were obtained for B cell precursor common ALL and other subgroups, as well as for cases diagnosed above and below age 5 years. Conclusion: These results support the hypothesis that reduced exposure to infection in the first few months of life increases the risk of developing acute lymphoblastic leukaemia.展开更多
Background. - Cancer in childhood account for less than 1% of all cancers and for the second most important cause of death for children aged less than 15 years in France, injuries being the leading cause. Compared to ...Background. - Cancer in childhood account for less than 1% of all cancers and for the second most important cause of death for children aged less than 15 years in France, injuries being the leading cause. Compared to adult cancers, childhood cancers’ particularities justify to create pediatric registries. The first French population-based registry was created in Lorraine in 1983. The incidence and survival results from a 17 year-period are presented. Methods. - In Lorraine region, all children (0- 14 years) with cancer diagnosed between 1983 and 1999 were included. Crude, age-standardized (world population) and cumulative incidence rates were calculated just as overall, specific- disease and event-free survival rates, using Kaplan-Meier methods. Results. - With 1086 registered cases, the crude incidence rate per million children is 132.4, the age-standardized incidence rate per million is 137.5; 1 out of every 500 children will develop cancer before the age of 15 years. The incidence of all cancers combined is slightly higher in males than in females with a M/F ratio of 1.13. For this 17 years-period, no trend in childhood cancer incidence is observed. The main cancer groups are leukemia (30.7% ), brain and spinal tumors (23.2% )- and lymphomas (12.9% ), sympathetic nervous system tumors (7.4% ), soft-tissue sarcomas (6.1% ), renal tumors (5.2% ), and bone tumors (5.0% ). Five-year specific survival rates for all cancers combined is 71.4% [95% CI: 68.5- 74.3]. The prognosis is significatively worse for the< 1 year age group (55% ) and for some histologic types: brain stem gliomas (27% ), hepatic tumors (43% ), osteosarcomas (57% ), neuroblastomas (65% ), rhabdomyosarcomas (55% ). Discussion. - Relative distribution of histologic groups, incidence and survival rates observed in Lorraine registry are compatible with the general pattern in the European Union cancer registries. The lack of significative trend in incidence unlike others country may be explained by too small numbers. Conclusion. - The acquired experience in developping this regional registry allowed us to create a national registry of childhood solid tumors and contribute to valid national data.展开更多
文摘Objective. To assess the health-related quality of life (HRQL) of 8-to 12-year-old children undergoing therapy for cancer or childhood-cancer survivors by using the Minneapolis-Manchester Quality of Life-Youth Form(MMQL-YF),a comprehensive,multidimensional self-report instrument with demonstrable reliability and validity. Design,Setting,and Patients. The MMQL-YF consists of 32 items comprising 4 scales:physical functioning,psychologic functioning,physical symptoms,and outlook on life. Scoring on the MMQL ranges from 1 to 5; 5 indicates maximal HRQL. An overall quality-of life (QOL) score is also computed. By using a cross-sectional study design,the MMQL-YF was administered to 90 off-therapy cancer survivors,72 children with cancer undergoing active therapy,and 481 healthy children without a history of cancer or other chronic disease. Results. Compared with healthy controls,children actively undergoing cancer treatment report low overall QOL,physical functioning,and outlook-on-life scores. However,off-therapy survivors report a superior overall QOL,compared with age-matched healthy controls. Conclusions. Young survivors of childhood cancer report a favorable HRQL relative to healthy controls. These results are reassuring,suggesting that this group of survivors may have been too young to encounter some of the negative psychosocial impacts of cancer and its treatment.
文摘Objective: To test the hypothesis that reduced exposure to common infections in the first year of life increases the risk of developing acute lymphoblastic leukaemia. Design and setting: The United Kingdom childhood cancer study (UKCCS) is a large population based case-control study of childhood cancer across 10 regions of the UK Participants 6305 children (aged 2-14 years) without cancer; 3140 children with cancer (diagnosed 1991-6), of whom 1286 had acute lymphoblastic leukaemia (ALL). Main outcome measure: Day care and social activity during the first year of life were used as proxies for potential exposure to infection in infancy. Results: Increasing levels of social activity were associated with consistent reductions in risk of ALL; a dose-response trend was seen. When children whose mothers reported no regular activity outside the family were used as the reference group, odds ratios for increasing levels of activity were 0.73 (95%confidence interval 0.62 to 0.87) for any social activity, 0.62 (0.51 to 0.75) for regular day care outside the home, and 0.48 (0.37 to 0.62) for formal day care (attendance at facility with at least four children at least twice a week) (P value for trend < 0.001). Although not as striking, results for non-ALL malignancies showed a similar pattern (P value for trend < 0.001). When children with non-ALL malignancies were taken as the reference group, a significant protective effect for ALL was seen only for formal day care (odds ratio = 0.69, 0.51 to 0.93; P = 0.02). Similar results were obtained for B cell precursor common ALL and other subgroups, as well as for cases diagnosed above and below age 5 years. Conclusion: These results support the hypothesis that reduced exposure to infection in the first few months of life increases the risk of developing acute lymphoblastic leukaemia.
文摘Background. - Cancer in childhood account for less than 1% of all cancers and for the second most important cause of death for children aged less than 15 years in France, injuries being the leading cause. Compared to adult cancers, childhood cancers’ particularities justify to create pediatric registries. The first French population-based registry was created in Lorraine in 1983. The incidence and survival results from a 17 year-period are presented. Methods. - In Lorraine region, all children (0- 14 years) with cancer diagnosed between 1983 and 1999 were included. Crude, age-standardized (world population) and cumulative incidence rates were calculated just as overall, specific- disease and event-free survival rates, using Kaplan-Meier methods. Results. - With 1086 registered cases, the crude incidence rate per million children is 132.4, the age-standardized incidence rate per million is 137.5; 1 out of every 500 children will develop cancer before the age of 15 years. The incidence of all cancers combined is slightly higher in males than in females with a M/F ratio of 1.13. For this 17 years-period, no trend in childhood cancer incidence is observed. The main cancer groups are leukemia (30.7% ), brain and spinal tumors (23.2% )- and lymphomas (12.9% ), sympathetic nervous system tumors (7.4% ), soft-tissue sarcomas (6.1% ), renal tumors (5.2% ), and bone tumors (5.0% ). Five-year specific survival rates for all cancers combined is 71.4% [95% CI: 68.5- 74.3]. The prognosis is significatively worse for the< 1 year age group (55% ) and for some histologic types: brain stem gliomas (27% ), hepatic tumors (43% ), osteosarcomas (57% ), neuroblastomas (65% ), rhabdomyosarcomas (55% ). Discussion. - Relative distribution of histologic groups, incidence and survival rates observed in Lorraine registry are compatible with the general pattern in the European Union cancer registries. The lack of significative trend in incidence unlike others country may be explained by too small numbers. Conclusion. - The acquired experience in developping this regional registry allowed us to create a national registry of childhood solid tumors and contribute to valid national data.
