1224 Twenty-five years of registering paediatric cancers in South Africa

One must acknowledge the work of the SACCSG (South African Children’s Cancer Study Group) (assisted for the past several years by the Childhood Cancer Foundation of South Africa) in establishing and maintaining the South African Children’s Tumour Registry which since 1987 has been capturing valuable data (e.g. age-specific incidences, relative frequencies of various neoplasms, prevalence of childhood cancer, distribution according to gender, ethnicity and geographical area). This has facilitated analysis of tumour sub-types, stages of malignancies and outcomes. Hosted over the years by various paediatric oncology units around the country, for the past 15 years it has been kept at Stellenbosch University. While early efforts by the National Health Laboratory Service to develop and maintain a National Cancer Registry were less than successful, the Registry was revitalised in 2011 with the introduction of regulations that require all cancers in adults and children to be reported. The SACCSG supports the National Registry but will continue to collect and promote the Children’s Tumour Registry in order to adequately address the needs of patients and researchers in the field of paediatric oncology. Results presented for the period 1997-2007 show an annual incidence of ~550 to ~650, with occasional spikes to above 700. Leukaemias represent around 25%, with lymphomas, CNS tumours, nephroblastoma at ~13% each and sarcoma at ~10%. The most striking feature is that when 1987-1997 is compared to 1998-2007, brain tumours decreased by 50% while epithelial tumours doubled, mostly due to the increase in Kaposi sarcomas. Also of note is that the 33.4-47.2/million incidence in 0-14 year olds that was reported for the period 2003-2007 was one-third to one-quarter that of the USA or Europe. This difference is worthy of further study – is it the result of failure to diagnose cancer in this country, under-referral to specialist centres, and/ or non-submission of data to academic centres and the Registry by private practitioners, or is the rate actually lower? Going forward, comparison of data recorded on the two registers (Children’s Tumour Registry and National Cancer Registry) might shed some light on that question.

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