Cancer morbidity in children under three years of age in Voronezh and Voronezh Oblast

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Relevance. Approximately 400,000 children and adolescents aged from birth to 18 years get cancer annually in the world [1]. In the Russian Federation, malignant neoplasms (MNEs) are in the 5th place among the causes of death of the child population from 0 to 17 years of age [2]. To control the prevalence of MND in the world, including Russia, epidemiologic studies are conducted, thanks to which the risk levels of developing a particular type of oncology in different, including age groups, are assessed [3]. At the end of 2018, about 27 thousand children were under dispensary observation in oncological institutions of the Russian Federation - this is almost 40% more than a decade ago. In 2018, the rate of pediatric oncologic morbidity in Russia was 12.9 per 100 thousand children aged 0 to 17 years [4]. Its maximum level was recorded in the age group from 0 to 4 years: 19.1 in boys and 16.8 in girls. According to the literature, the structure of the incidence of STDs in the Russian child population has remained the same over the last decade: the leading place was occupied by hemoblastoses - 53.8%, followed by solid tumors - 52.4%, their most frequent localizations were the brain and other parts of the nervous system - 16.8%, then the kidney - 6.3%, then soft tissues - 5.5%, bones and articular cartilage - 3.9%, eyes - 3.2% and other, more rare localizations. In connection with the above, it is clear that the problem of oncologic morbidity in children, including early childhood, remains urgent.

Purpose of the study: to determine the proportion of children under 3 years of age among all statistically registered cases of pediatric oncologic morbidity in Voronezh city and Voronezh region for the last 6 years (2018 - 2023) and to analyze the obtained data by sex of children, by place of residence, by nosological forms of diseases.
Materials and methods: the medical records of oncological patients under 3 years of age who were on inpatient examination and treatment in the oncohematologic chemotherapy department of BUZ VODKB №1 during the above period were analyzed.
Results of the study. As a result of the study, it was found out that in the period from 2018 to 2023, the total number of children admitted for the first time to the oncohematologic chemotherapy department of BUZ VODKB No. 1 with oncologic diagnosis was 333 people; of them, 91 patients (27.3%) under the age of 3 years old.

Table 1.
Number of children with MND treated in the oncohematologic chemotherapy department of BUZ VO "VODKB №1" in the period of 2018-2023, with allocation of the share of
children up to 3 years old

Year	Total number of newly diagnosed patients	Total number of newly diagnosed patientsNumber of patients under 3 years of age (n)	%
2018	70	22	31,4%
2019	64	22	34,4%
2020	55	14	25,5%
2021	53	16	30,2%
2022	52	6	11,5%
2023	41	11	26,8%
Итого	333	91	27,3%

 

Analysis of data by year showed that the specific weight of children under 3 years of age in the total structure of detected cancer diseases ranged from 11.5% (2022) to 34.4% (2019).
When analyzing the sex structure of children, it was found that in total among those who became ill between 2018 and 2023, boys slightly predominated: 55.1% versus 42.9% of girls. This trend persisted for almost all 6 years of follow-up; the highest predominance of boys was observed in 2018 (63.6%) and in 2021 (62.5%).

 

Table 2.
Sex composition of children with MND up to 3 years of age treated in the oncohematologic chemotherapy department of BUZ VO "VODKB №1"
in the period 2018-2023

в период 2018-2023 г.г.

Year	Total number of patients under 3 years of age	Boys (n, %)	Girls (n, %)
2018	22	14 (63,6%)	8 (36,4%)
2019	22	12 (54,5%)	10 (45,5%)
2020	14	8 (57,1%)	6 (42,9%)
2021	16	10 (62,5%)	6 (37,5%)
2022	6	2 (33,3%)	4 (66,7%)
2023	11	6 (54,5%)	5 (45,5%)
Итого	91	52 (57,1%)	39 (42,9%)

 

Regarding the place of residence of sick children under 3 years of age with malignant neoplasms detected in 2018-2023, there was an overall predominance of urban residents compared to rural residents - 57.1% vs. 42.9%. In 2020 and 2023, there was a clear predominance of urban residents, 71.4% and 72.7%, respectively.

Table 3.
Analysis of the place of residence of children with MND up to 3 years of age treated in the oncohematologic chemotherapy department of BUZ VO "VODKB №1"
in the period 2018-2023

Year	Total number of patients under 3 years of age	Residents of Voronezh (n, %)	Residents of Voronezh Oblast (n, %)
2018	22	12 (54,5%)	10 (45,5%)
2019	22	11 (50,0%)	11 (50,0%)
2020	14	10 (71,4%)	4 (28,6%)
2021	16	8 (50,0%)	8 (50,0%)
2022	6	3 (50,0%)	3 (50,0%)
2023	11	8 (72,7%)	3 (27,3%)
Итого	91	52 (57,1%)	39 (42,9%)

 

Having analyzed the nosological structure of oncological morbidity in children under 3 years of age, we noted the following: acute leukemia was the most frequent disease in patients of this age group (38.5%), neuroblastoma was the second most frequent (17.6%). Brain tumors and nephroblastoma each accounted for 8.8% of the total morbidity. Rhabdomyosarcoma (6.6%), retinoblastoma (4.4%), and hepatoblastoma (3.3%) occurred with decreasing frequency. There were also other nosological variants: non-Hodgkin's lymphoma, yolk sac tumor, teratoma, fibrosarcoma, but they were single.

Table 4.
Nosologic structure of oncologic morbidity of children under 3 years of age treated in the oncohematologic chemotherapy department of BUZ VO "VODKB №1"
in the period 2018-2023

 

Year Nozology	2018	2019	2020	2021	2022	2023	Итого
Acute leukemia	9 (41%)	6 (27,2%)	3 (21,4%)	6 (37,5%)	4 (66,6%)	7 (63,6%)	35 (38,5%)
Neuro-blastoma	8 (36,3%)	3 (13,6%)	3 (21,4%)	1 (6,3%)	0	1 (9,0%)	16 (17,6%)
Nephro-blastoma	1 (4,5%)	2  (9,0%)	2 (14,3%)	2 (12,5%)	0	1 (9,0%)	8 (8,8%)
Brain tumor	0	3 (13,6%)	1 (7,0%)	3 (18,8%)	0	1 (9,0%)	8 (8,8%)
Rhabdomyosarcoma	1 (4,5%)	1 (4,5%)	2 (14,3%)	0	1 (16,7%)	1 (9,0%)	6 (6,6%)
Retinoblastoma	0	2 (9,0%)	1 (7%)	1 (6,25%)	0	0	4 (4,4%)
Hepato-blastoma	0	1 (4,5%)	0	1 (6,3%)	1 (16,7%)	0	3 (3,3%)
Other tumors	3 (13,7%)	4 (18,6%)	2 (14,3%)	2 (12,5%)	0	0	11 (12,0%)

We were especially interested in the group of children of the youngest age - the first year of life. In the structure of all children with MND up to 3 years of age, the share of children of the first year of life averaged 28.6%, but by years was quite unstable - from 18.2% to 45.4%.

Table 5.
Number of children of the first year with MND treated in the oncohematology chemotherapy department of BUZ VO "VODKB №1" in the period of 2018-2023 years

Year	Number of patients with MND up to 3 years (n)	Number of patients with MND in the first year of life (n)	%
2018	22	4	18,2%
2019	22	9	40,9%
2020	14	3	21,4%
2021	16	3	18,8%
2022	6	2	33,3%
2023	11	5	45,4%
Итого	91	26	28,6%

Neuroblastomas prevailed in the disease structure (26.9%), leukemia (23.1%) came second, followed by brain tumors (11.5%). Hepatoblastomas, retinoblastomas and nephroblastomas were equally distributed (7.7%), 1 case each of rhabdomyosarcoma and fibrosarcoma.

Conclusion. Thus, every year in the city of Voronezh and Voronezh region 50-70 children are diagnosed with some kind of oncologic disease. Children under 3 years of age make up 27.3% of all patients, children of the first year of life - 28.6% of all children under 3 years of age. There is a slight predominance of boys among children under 3 years of age. The leading nosological unit among children under 3 years of age is acute leukemia, among children of the first year of life - neuroblastoma. In terms of territory, it was revealed that the number of MND patients in the city prevails over the number of similar patients in rural areas, which may be due to the presence of a greater number of harmful anthropogenic factors within the city and unfavorable environmental conditions there.

About the authors

Maya Sergeevna Prohorova

Voronezh State Medical University named after N.N. Burdenko

Author for correspondence.
Email: prohorova_mayya@mail.ru
ORCID iD: 0009-0002-7628-4129

4th-year student of pediatric faculty

Russian Federation, 10 Studencheskaya St., Voronezh, 394036, Russia

Galina Gennadevna Volosovets

Burdenko Voronezh State Medical University

Email: volga-6@mail.ru
ORCID iD: 0000-0003-2862-6411

MD, Assistant of the Department of Hospital Pediatrics

Russian Federation, 10 Studencheskaya St., Voronezh, 394036, Russia

Natalia Borisovna Yudina

Voronezh Regional Children's Clinical Hospital №1

Email: n.yudina@list.ru
ORCID iD: 0000-0002-7305-6959

Head of Oncohematology Chemotherapy Department, BOOZ VO ODKB № 1

Russian Federation, 114, 114/49 Lomonosova St., Voronezh, Russia, 394087, Russia

References

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