Clinical and Translational Oncology

, Volume 20, Issue 10, pp 1289–1301 | Cite as

Childhood and adolescent lymphoma in Spain: incidence and survival trends over 20 years

  • R. Marcos-Gragera
  • M. Solans
  • J. Galceran
  • R. Fernández-Delgado
  • A. Fernández-Teijeiro
  • A. Mateos
  • J. R. Quirós-Garcia
  • N. Fuster-Camarena
  • V. De Castro
  • M. J. Sánchez
  • P. Franch
  • M. D. Chirlaque
  • E. Ardanaz
  • C. Martos
  • D. Salmerón
  • R. Peris-Bonet
  • The Spanish Childhood Cancer Epidemiology Working Group
Research Article



Lymphoma is the third most common malignancy in children (0–14 years) and the first in adolescents (15–19 years). This population-based study—the largest ever done in Spain—analyses incidence and survival of lymphomas among Spanish children and adolescents.

Patients and methods

1664 lymphoma cases (1983–2007) for incidence and 1030 for survival (1991–2005) followed until 31/12/2010, were provided by 11 cancer registries. Age-adjusted incidence rates (ASRw) to the world standard population were obtained; incidence trends were modelled using the Joinpoint programme, observed survival (OS) was estimated with Kaplan–Meier and trends tested with a log-rank test. Results are presented according to the International Classification of Childhood Cancer-3.


In Spain, the ASRw0–14 for lymphomas was 17.5 per 1.000.000 child-years and 50.0 the specific rate for adolescents. Overall incidence increased significantly during 1983–1997 with no increases thereafter. Patients over 9 years old showed significant rising trends for all subtypes, except for Burkitt lymphoma (BL) in adolescents. During 2001–2005 (age 0–19 years), 5-year OS was 94 (90–98), 73 (64–83) and 86 (78–94) for Hodgkin lymphoma (HL), non-Hodgkin lymphoma (NHL) and BL, respectively. No improvement in survival was found. The incidence in Spain was higher than overall European rates, but within the range of that in Southern Europe. Comparing OS in Spain 1991–1995 and 2001–2005 with results for Europe of the Automated Childhood Cancer Information System (ACCIS) (1988–1997) and the European cancer registry-based study on survival and care of cancer patients (EUROCARE) (2000–2007), it was similar for HL and lower for NHL and BL.


Systematic monitoring and analysis of lymphoma paediatric data would provide clinical and epidemiological information to improve the health care of these patients and the outcomes for these malignancies in Spain.


Childhood and adolescent cancer Lymphoma Incidence Survival Population based Cancer registry Spain 



This work was supported by FIS (PI 061742) and (PI 10/01617); Enriqueta Villavecchia Foundation; Red de Investigación Temática en Cáncer RD12/0036/0056 (RMG) and RD12/0036/0053 (RPB and JG); and CIBERESP (predoctoral contract to MS). The authors thank E Pardo and A Muñoz for their contribution to the analysis and the critic review of the manuscript.

The Spanish Childhood Cancer Epidemiology Working Group for this study includes also the following cancer registries and collaborators: Albacete (E. Almar, A. Mateos), Asturias (J. R. Quirós), Basque Country (L. Gil, A. López de Munain), Childhood Cancer Registry of the Comunitat Valenciana (C. Sabater, M. Vicente), Girona (R. Marcos-Gragera, L. Vilardell), Granada (M. Rodríguez-Barranco, D. Y. Chang), Mallorca (P. Franch, M. Ramos), Murcia (C. Navarro, M. D. Chirlaque), Navarra (M. Guevara, R. Burgui), Tarragona (M. Carulla, A. Ameijide), Zaragoza (C. Martos) and the Spanish Registry of Childhood Tumours (RETI-SEHOP) (E. Pardo, A. Muñoz).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study formal consent is not required.


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Copyright information

© Federación de Sociedades Españolas de Oncología (FESEO) 2018

Authors and Affiliations

  • R. Marcos-Gragera
    • 1
    • 2
  • M. Solans
    • 1
    • 2
    • 3
  • J. Galceran
    • 4
    • 5
    • 6
  • R. Fernández-Delgado
    • 7
    • 8
  • A. Fernández-Teijeiro
    • 9
    • 10
  • A. Mateos
    • 11
  • J. R. Quirós-Garcia
    • 12
  • N. Fuster-Camarena
    • 13
  • V. De Castro
    • 14
  • M. J. Sánchez
    • 3
    • 15
  • P. Franch
    • 16
  • M. D. Chirlaque
    • 3
    • 17
  • E. Ardanaz
    • 3
    • 18
    • 19
  • C. Martos
    • 20
    • 21
  • D. Salmerón
    • 3
    • 22
    • 23
  • R. Peris-Bonet
    • 24
  • The Spanish Childhood Cancer Epidemiology Working Group
  1. 1.Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of HealthAutonomous Government of Catalonia, Catalan Institute of OncologyGironaSpain
  2. 2.Research Group on Statistics, Econometrics and Health (GRECS)University of GironaGironaSpain
  3. 3.CIBER in Epidemiology and Public Health (CIBERESP)MadridSpain
  4. 4.Tarragona Cancer RegistryFoundation Society for Cancer Research and Prevention (FUNCA)ReusSpain
  5. 5.Pere Virgili Health Research InstituteReusSpain
  6. 6.Rovira i Virgili University (URV)ReusSpain
  7. 7.Department of Paediatrics, Obstetrics and GynaecologyUniversity of ValenciaValenciaSpain
  8. 8.Non-Hodgkin Lymphoma Working GroupSpanish Society of Paediatric Haematology and Oncology (SEHOP)MadridSpain
  9. 9.University Hospital Virgen de la MacarenaSevillaSpain
  10. 10.Hodgkin Lymphoma Working GroupSpanish Society of Paediatric Haematology and Oncology, (SEHOP)MadridSpain
  11. 11.Albacete Cancer Registry, Health and Social Welfare AuthorityAlbaceteSpain
  12. 12.Asturias Cancer Registry. Public Health DirectorateAsturiasSpain
  13. 13.Childhood Cancer Registry of the C. Valenciana, Public Health Directorate, Health DepartmentGovernment of C.ValencianaValenciaSpain
  14. 14.Basque Country Cancer Registry, Basque GovernmentBilbaoSpain
  15. 15.Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs.GRANADA, Hospitales Universitarios de Granada/Universidad de GranadaGranadaSpain
  16. 16.Mallorca Cancer Registry, Epidemiology DepartmentDirectorate-General of Public Health and ParticipationPalma de MallorcaSpain
  17. 17.Department of EpidemiologyMurcia Regional Health Council, IMIB-Arrixaca, Murcia UniversityMurciaSpain
  18. 18.Navarra Public Health InstitutePamplonaSpain
  19. 19.IdiSNA, Navarra Institute for Health ResearchPamplonaSpain
  20. 20.Instituto Aragonés de Ciencias de la SaludZaragozaSpain
  21. 21.Centre of Public Health Research-FISABIOValenciaSpain
  22. 22.Department of Health and Social SciencesUniversity of MurciaMurciaSpain
  23. 23.IMIB-ArrixacaMurciaSpain
  24. 24.Spanish Registry of Childhood Tumours (RETI-SEHOP)University of ValenciaValenciaSpain

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