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Incidence


Leukaemia is a cancer of the blood. It is the most common childhood cancer, with around 500 children diagnosed in the UK every year.

Almost one third of all children diagnosed with cancer will have leukaemia.

The most common type of childhood leukaemia is acute lymphoblastic leukaemia (ALL). Up to 400 children are diagnosed with ALL every year in the UK, which accounts for 80 per cent of all cases of childhood leukaemia.

Most of the remaining cases are acute myeloid leukaemia (AML). Around 70 children are diagnosed with AML annually in the UK.

Chronic myeloid leukaemia (CML) makes up less than 5 per cent of the total (less than 15 children per year in the UK).

Childhood leukaemia and age

The incidence of childhood leukaemia varies with age.

The risk of ALL increases rapidly after birth, peaks around the third or fourth year of life and then declines. This is known as the early childhood peak.  

In contrast to the age incidence pattern of ALL, the highest risk of AML is in children aged less than two years. The risk in children aged two to nine years is lower and it then rises through the adolescent years.

Gender differences

Boys are at higher risk than girls of developing leukaemia. Almost 25 per cent more boys than girls develop leukaemia.

Boys also have a worse prognosis - boys with ALL need an extra year of treatment compared to girls, to guard against relapse.

The reason for this difference between the sexes is not known.

Increasing incidence

Incidence of childhood leukaemia appears to have increased steadily throughout the 20th century, although in recent years it does appear to have plateaued.

National records of childhood leukaemia incidence were not kept before 1962 although mortality data were recorded from 1911. Until the 1960s, however, leukaemia in children was almost always fatal and so mortality rates are a reasonably accurate reflection of incidence rates.

A study of childhood cancer rates in Europe showed an average annual increase of 1.4% in childhood lymphoid leukaemia during 1970-1999 (1).

The increasing incidence appears to affect mainly the under-five age group with incidence in older children remaining fairly static. Under-fives now account for more than half of all cases.

Worldwide incidence

The annual incidence rate of childhood leukaemia varies world-wide between 20 and 60 cases per million (2). The annual incidence rate in England and Wales in the period 1996–2000 was 46.1 per million.

More affluent countries generally tend to have higher incidence rates (with Switzerland, Finland and Italy having amongst the highest rates in the world) whilst less developed countries have some of the lowest rates. India and countries in Africa are amongst those with the lowest rates.

Incidence rates also vary by ethnicity within countries, as seen in the USA - the leukaemia incidence rates in white children (45.6 per million) are almost twice those in black children (27.8 per million) during the period 1986-95 (3). Incidence is high amongst Hispanics living in California (over 50 per million).

1. Steliarova-Foucher E, Still CA, Kaatsch P, Berrino F, Coeberg JWW, Lacour B, Parkin M. Geographical patterns and time trends of cancer incidence and survival among children and adolescents in Europe since the 1970s (the ACCIS project): an epidemiological study. Lancet 2004; 364: 2097-2105.

2. International Incidence of Childhood Cancer Vol II. IARC Scientific Publications No. 144. Parkin DM et al. Lyon International Agency for Research on Cancer, 1998.

3. Smith MA, Gloecker Ries LA, Gurney JG, Ross JA. Leukaemia. In: Ries LAG, Smith MA, Gurney JG, Linet M, Tamra T, Young JL et al. eds. Cancer incidence and survival among children and adolescents:United States SEER Program 1975-1995. NIH Pub No 99-4649 Bethesda, Maryland: National Cancer Institute, SEER Program, 1999.
Related Topics acute myeloid leukaemia, Chronic myeloid leukaemia, leukaemia incidence, acute lymphoblastic leukaemia

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