Essential Site Maintenance: Authorea-powered sites will be updated circa 15:00-17:00 Eastern on Tuesday 5 November.
There should be no interruption to normal services, but please contact us at [email protected] in case you face any issues.

loading page

A Sunnier Forecast But Still Some Clouds: Trends in Pediatric Cancer Care in Florida from 1981-2020
  • +13
  • Peter Shaw,
  • Jonathan Metts,
  • Ernest Amankwah,
  • Don Eslin,
  • Scott Bradfield ,
  • William Slayton,
  • Brian Hays ,
  • Brian Calkins ,
  • Craig MacArthur,
  • Juan Rico,
  • Julio Barredo,
  • Amy Smith,
  • Iftikhar Hanif,
  • Hector Rodriguez-Cortes,
  • Ramamoorthy Nagasubramanian,
  • Jeffrey Krischer
Peter Shaw
All Children's Hospital

Corresponding Author:[email protected]

Author Profile
Jonathan Metts
Johns Hopkins All Children's Hospital
Author Profile
Ernest Amankwah
Johns Hopkins University
Author Profile
Don Eslin
Saint Joseph's Children's Hospital
Author Profile
Scott Bradfield
Nemours Children's Health System
Author Profile
William Slayton
University of Florida
Author Profile
Brian Hays
University of South Florida
Author Profile
Brian Calkins
University of South Florida
Author Profile
Craig MacArthur
Golisano Children's Hospital of Southwest Florida
Author Profile
Juan Rico
University of South Florida
Author Profile
Julio Barredo
University of Miami
Author Profile
Amy Smith
Arnold Palmer Hospital for Children
Author Profile
Iftikhar Hanif
Joe DiMaggio Children's Hospital
Author Profile
Hector Rodriguez-Cortes
Broward General Medical Center
Author Profile
Ramamoorthy Nagasubramanian
Nemours Children\'s Clinic
Author Profile
Jeffrey Krischer
University of South Florida
Author Profile

Abstract

Background: The Florida Association of Pediatric Tumor Programs (FAPTP) has used the Statewide Patient Information Reporting System (SPIRS) since 1980 to track all cases of pediatric cancer. We reviewed the last 40 years of SPIRS data to see how pediatric cancer care has evolved. Methods: We retrospectively analyzed the SPIRS data from 1980 through 2020 in 5-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 with the median age increasing from 6 to 9. 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%) and those with known follow-up rose from 65% to 94%, an APC of 4.5% (95% CI of 3 to 6%). The rate of COG clinical trial enrollment decreased from 32% in 1981-1985 to 20% from 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 clinical trials. Improved access to care has not translated into a higher rates of trial enrollment, a deficit which merits further investigation and initiatives.