Georgia epidemiology report, Vol. 18, no. 12 (Dec. 2002)

December 2002

volume 18 number 12

Division of Public Health http://health.state.ga.us
Kathleen E. Toomey, M.D., M.P.H. Director
State Health Officer
Epidemiology Branch http://health.state.ga.us/epi
Paul A. Blake, M.D., M.P.H. Director
State Epidemiologist
Mel Ralston Public Health Advisor
Georgia Epidemiology Report Editorial Board
Carol A. Hoban, M.S., M.P.H. - Editor Kathryn E. Arnold, M.D.
Paul A. Blake, M.D., M.P.H. Susan Lance-Parker, D.V.M., Ph.D. Kathleen E. Toomey, M.D., M.P.H.
Angela Alexander - Mailing List Jimmy Clanton, Jr. - Graphic Designer

Highlights from the Georgia Childhood Cancer Report 2002
Introduction
Cancer is the third most common cause of death among children between 1 and 19 years of age, accounting for 6% of childhood mortality in Georgia in 1999 (Figure 1). The most common forms of childhood cancer, leukemias, central nervous system (CNS) neoplasms, and lymphomas account for almost 50% of all childhood cancer diagnoses and over 60% of childhood cancer deaths (Table 1).
The Georgia Childhood Cancer Report 2002 was written to assist health professionals, volunteers, and staff of cancer control organizations, community groups, and others who are working to reduce the burden of cancer throughout Georgia. The full report is available at http://www.ph.state.ga.us/pdfs/chronic/cancer/childcancer.02.pdf.
Figure 1. Childhood Mortality by Cause, Ages 1 to 19 Years, Georgia, 1999 (n=901)

Homicide 11% (n=98)

Cancer 6% (n=58) Suicide
6% (n=58)
Heart Disease 5% (n=41) Congenital Malformations 4% (n=38)

Unintentional Injuries
47% (n=419)

Other 21% (n=189)

Table 1. Incidence vs Mortality for the Top Three Cancer Sites in Children Ages 0 to 19 Years in Georgia

Georgia Department of Human Resources
Division of Public Health Epidemiology Branch
Two Peachtree St., N.W. Atlanta, GA 30303-3186 Phone: (404) 657-2588
Fax: (404) 657-7517
Please send comments to: Gaepinfo@dhr.state.ga.us
The Georgia Epidemiology Report is a publication of the Epidemiology Branch,
Division of Public Health, Georgia Department of Human Resources

Leukemia CNS Cancer Lymphoma

Incidence

% of Cases Cases*

22%

75

15%

50

12%

40

Mortality

% of Deaths Deaths

30%

16

23%

12

8%

4

*Estimated cases per year in Georgia. Figures have been rounded to the nearest five.

The Georgia Epidemiology Report Via E-Mail
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Methods

The counties with the most complete long-term cancer incidence data were included in the incidence analysis. They include the five counties in Metro Atlanta and the ten rural counties served by the Surveillance, Epidemiology, and End Results (SEER) Program and

the eleven counties that were originally part of the Savannah River Region Health Information System (SRRHIS) (Figure 2). These counties represent 45% of the total population in Georgia.

Figure 2. Georgia Counties Included in the Childhood Cancer Incidence Analysis

SEER Metro Atlanta Counties SEER Rural Counties SRRHIS Counties

SEER Metro Atlanta Counties: Clayton, Cobb, Dekalb, Fulton, and Gwinnett.
SEER Rural Counties: Glascock, Greene, Hancock, Jasper, Jefferson, Morgan, Putnam, Taliaferro, Warren, and Washington.
SRRHIS Counties: Bryan, Bulloch, Burke, Chatham, Columbia, Effingham, Evans, Jefferson, Jenkins, McDuffie, Richmond, and Screven.

Results

Childhood Cancer Incidence in Georgia (Selected Counties)

Childhood Cancer Mortality in Georgia

Between 1993 and 1997, there were 729 cancer diagnoses among chil- Between 1990 and 1999, there were 523 cancer deaths among Georgia's

dren aged 0 to 19 years living in Georgia's SEER and SRRHIS counties.

children aged 0 to 19 years. The age-adjusted rate for this time period

The age-adjusted incidence rate for this time period was 154.2 per

was 24.9 per 1,000,000.

1,000,000.

The highest cancer mortality rate (7.5 per 1,000,000) among children

The highest cancer incidence rate (34.2 per 1,000,000) among children

aged 0 to 19 years was for leukemia, followed by CNS neoplasms with a

aged 0 to 19 years was leukemia, followed by CNS neoplasms with a

rate of 5.6 per 1,000,000.

rate of 23.5 per 1,000,000.

Overall, males had a slightly higher cancer mortality rate than females.

Overall, males had a higher cancer incidence rate than females. This

This difference was most apparent in the 15 to 19 year old age group.

difference was most apparent in leukemias, lymphomas, and soft tissue Cancer mortality increased with age, with the 15 to 19 year old age

sarcomas.

group having the highest number of cancer deaths among children for

Children aged 0 to 4 years were most likely to be diagnosed with

most cancer types.

leukemias, neuroblastomas, or renal tumors. Children aged 15 to 19 Mortality rates for all childhood cancers combined decreased steadily

years were more likely to be diagnosed with lymphomas, especially Hodgkin's lymphoma.

from 1979 to 1999 in Georgia (Figure 4). This decrease results from improvements in survival for most childhood cancers, especially leuke-

Incidence rates for all childhood cancers combined increased steadily

mia and lymphoma.

from 1975 to 1998 in Metro Atlanta (Figure 3). At least some of this

increase is due to changes in diagnostic technology, reporting, and

classification.

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Rate per 1,000,000

Figure 3. Childhood Cancer Incidence Rates* Metro Atlanta, All Sites, Ages 0 to 19, 1975-1998
200.0 180.0 160.0 140.0 120.0 100.0
80.0 60.0
EAPC**=1.4%
40.0 20.0
0.0 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 199 Year of Diagnosis
* Rate per 1,000,000, age-adjusted to the 1970 US standard population **Estimated Annual Percent Change

Figure 4. Childhood Cancer Mortality Rates* Georgia, All Sites, Ages 0 to 19, 1979-1999

60.0

50.0

Rate per 1,000,000

40.0

30.0

20.0

ICD-9

ICD-10

10.0
EAPC**=-0.6%
0.0 1979 1981 1983 1985 1987 1989 1991 1993 1995 1997 1999
Year of Death
* Rate per 1,000,000, age-adjusted to the 1970 US standard population **Estimated Annual Percent Change

Conclusion

Childhood cancers are uncommon but they remain an important public

recent decades, the treatment of childhood cancers has improved

health issue. The information in the Georgia Childhood Cancer Report

markedly. Presently more than 75% of children with cancer survive 5

2002 summarizes current incidence and mortality rates for childhood can-

years or more. National estimates suggest that about 20% of children

cers in Georgia. It also provides short summaries about what is known

with cancer may not receive the most appropriate treatment.

about the more common types of childhood cancers. The information will

be useful to many individuals concerned about cancer such as public health Improve the quality of information about childhood cancer in Georgia. Presently,

workers, health care providers, volunteer workers and groups, and families and friends of children with cancer. The report also calls attention to needed actions.

accurate and reliable information about childhood cancer in Georgia is available for only the 26 counties included in this report. The quality of information reported by hospitals and other cancer care

To reduce the incidence and mortality from childhood cancers, several steps are being taken:

providers to the Georgia Comprehensive Cancer Registry varies across the state but is improving. Efforts to achieve accurate and reliable information from the entire state are in progress.

Search for causes so that childhood cancer can be prevented. The cause or Thus, by participating in the search for causes, by assuring access to appro-
causes of most childhood cancers are unknown, making preventive priate treatment, and by improving the quality of information contained in actions impossible. The search for causes is difficult because the the Georgia Comprehensive Cancer Registry, Georgians will be participatcancers are rare. Efforts are underway to pool information from ing in efforts to reduce the burden of childhood cancers, a group of states with high quality cancer registries for the purposes of research. uncommon but devastating illnesses. Georgia will participate in these group research projects.
This article was written by Chrissy McNamara, M.S.P.H., A. Rana Bayakly,
Assure that every child with cancer in Georgia has access to the best treatment. In M.P.H., and Kenneth E. Powell, M.D., M.P.H.
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The Georgia Epidemiology Report Epidemiology Branch Two Peachtree St., NW Atlanta, GA 30303-3186

PRESORTED STANDARD U.S. POSTAGE
PAID ATLANTA, GA PERMIT NO. 4528

December 2002

Volume 18 Number 12

Reported Cases of Selected Notifiable Diseases in Georgia Profile* for September 2002

Selected Notifiable Diseases
Campylobacteriosis Chlamydia trachomatis Cryptosporidiosis E. coli O157:H7 Giardiasis Gonorrhea Haemophilus influenzae (invasive) Hepatitis A (acute) Hepatitis B (acute) Legionellosis Lyme Disease Meningococcal Disease (invasive) Mumps Pertussis Rubella Salmonellosis Shigellosis Syphilis - Primary Syphilis - Secondary Syphilis - Early Latent Syphilis - Other** Syphilis - Congenital Tuberculosis

Total Reported for September 2002
2002 31 1312 5 1 43 778 2 7 0 2 0 2 0 1 0 182 60 5 14 28 10 0 11

Previous 3 Months Total

Ending in September

2000

2001

2002

181

220

162

7825

8555

6185

79

61

34

23

13

13

382

305

240

5529

5080

3609

7

16

10

127

289

69

100

128

34

1

2

4

0

1

0

6

8

5

0

1

0

17

6

4

1

0

0

680

716

712

94

145

287

29

32

19

89

78

61

119

136

125

198

200

81

9

6

0

178

120

98

Previous 12 Months Total

Ending in September

2000

2001

2002

634

655

559

27771

31718

31264

190

160

124

51

35

53

1288

1032

829

18805

18428

17270

77

101

96

341

850

538

305

427

354

10

13

13

0

1

1

61

52

39

2

8

3

59

25

15

1

0

0

1786

1677

1779

300

367

1379

127

103

90

305

281

261

559

579

629

728

823

599

23

22

11

674

556

539

* The cumulative numbers in the above table reflect the date the disease was first diagnosed rather than the date the report was received at the state office, and therefore are subject to change over time due to late reporting. The 3 month delay in the disease profile for a given month is designed to minimize any changes that may occur. This method of summarizing data is expected to provide a better overall measure of disease trends and patterns in Georgia.

** Other syphilis includes latent (unknown duration), late latent, late with symptomatic manifestations, and neurosyphilis.

AIDS Profile Update

Report Period
Latest 12 Months: 11/01-10/02 Five Years Ago: 11/97-10/98 Cumulative: 07/81-10/02

Total Cases Reported* <13yrs >=13yrs Total

2

1,658 1,660

6

1,245 1,251

212

25,318 25,530

Percent Female
25.4
19.3
17.7

Risk Group Distribution (%) MSM IDU MSM&IDU HS Blood Unknown

39.4

7.1

2.5

13.8

2.0

35.2

41.4

19.2

5.9

16.1

1.0

16.4

47.6

17.3

5.4

13.4

1.9

14.3

Race Distribution (%) White Black Other

18.4 76.6

5.1

23.6 73.9

2.6

34.0 63.5

2.4

MSM - Men having sex with men

IDU - Injection drug users

HS - Heterosexual

* Case totals are accumulated by date of report to the Epidemiology Section

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