Trends in Pediatric Cancer Care in Florida From 1981-2020: Changing Patterns in a Growing and Increasingly Diverse Population

Peter H Shaw; Jonathan Metts; Ernest Amankwah; Don E Eslin; Scott Bradfield; William B Slayton; Brian Hays; Brian Calkins; Juan Rico; Jeffrey Krischer

doi:10.7759/cureus.35061

Trends in Pediatric Cancer Care in Florida From 1981-2020: Changing Patterns in a Growing and Increasingly Diverse Population

Cureus. 2023 Feb 16;15(2):e35061. doi: 10.7759/cureus.35061. eCollection 2023 Feb.

Authors

Affiliations

¹ Pediatrics/Oncology, Children's Wisconsin/Medical College of Wisconsin, Milwaukee, USA.
² Pediatric Oncology, Johns Hopkins All Children's Hospital, St. Petersburg, USA.
³ Oncology, Johns Hopkins All Children's Hospital, St. Petersburg, USA.
⁴ Pediatric Oncology, St. Joseph's Children's Hospital, Tampa, USA.
⁵ Pediatric Oncology, Nemours Children's Health System, Jacksonville, USA.
⁶ Pediatric Oncology, University of Florida College of Medicine, Gainesville, USA.
⁷ Epidemiology, University of South Florida Morsani College of Medicine, Tampa, USA.
⁸ Pediatric Hematology Oncology, University of South Florida Morsani College of Medicine, Tampa, USA.
⁹ Epidemiology and Biostatistics, University of South Florida Morsani College of Medicine, Tampa, USA.

Abstract

Background The Florida Association of Pediatric Tumor Programs (FAPTP) has used the Statewide Patient Information Reporting System (SPIRS) since 1981 to track all new cases of pediatric cancer. We reviewed the last 40 years of data to see how pediatric cancer care has evolved. Methods We retrospectively analyzed SPIRS data from 1981 through 2020 in five-year increments, looking at numbers of new diagnoses, care delivery sites, and trial enrollment in Children's Oncology Group (COG) studies. Results From 1981-2020 Florida's population increased almost 88% while the pediatric population only grew 61%. New pediatric cancer diagnoses increased 326% to over 1,000 new cases/year. The percentage of patients treated at FAPTP centers grew from 30% to 57% with an annual percentage change (APC) of 10.3% (95% Confidence Interval [CI] of 0.6 to 20.9%). The rate of COG clinical trial enrollment decreased from 32% in 1981-1985 to 20% in 2016-2020, for an APC of 8.91% (95% CI of -13.3 to -4.3%). Conclusions The striking increase in pediatric cancer cases in Florida over the last 40 years was out of proportion to the population growth. More patients received care at FAPTP centers, but a lower percentage were enrolled on COG trials.

Keywords: cancer epidemiology; cancer incidence; clinical trial enrollment; healthcare disparity; pediatric cancer.