Results
From 1981-2020 Florida’s population grew almost 88%, from 11.3 million
to 21.3 million inhabitants. Simultaneously the population under 21
grew only 61% while new documented pediatric cancer diagnoses increased
326% to over 1,000 new cases/year over the years 2016 to 2020. This
equates to an increase from 13.63 new cases per 100,000 population in
1981-1985 to 23.71 new cases per 100,000 population in 2016-2020 (see
Figure 1). The median age of pediatric cancer patients increased over
that time from 6 to 9 years old with a consistent gender breakdown of
55% male and 45% female patients.
During this time, SPIRS data demonstrate that the population of patients
became more racially and ethnically diverse. Between 1981 and 1985, 81%
of the patients in the database were white, 17% black and 1% unknown
or not reported, while between 2016 and 2020, 70% were white, 15% were
black and 12% were unknown or not reported (see Figure 2). When looking
at the ethnic breakdown as defined in SPIRS, from 1981 to 2020, we saw
the proportion of Hispanic or Latino patients rise from 14% to 30%
while those that did not identify as Hispanic or Latino decrease from
82% to 66% (see Figure 3). During this time, the state’s Hispanic
population grew from to 9% in 1980 to 26% in 2020. Asian patients made
up 1% of the cancer patients and this increased to 2% in the most
recent data set while those identified as “mixed race” rose from less
than 1% to 1% of the patients.
From 1981 through 2020, the percentage of patients treated at FAPTP
centers increased from 30% to 57% with an APC of
10.3% (95% Confidence Interval
[CI] of 0.6 to 20.9%) (see Figure 4). There was a significant
upward trend in the curve until around 2001, after which a plateau was
noted. Those patients with known follow-up after completion of treatment
rose from 65% to 94%, an APC of 4.5% (95% CI of 3 to 6%) (see
Figure 5). The total number of patients enrolled on large cooperative
group trials (CCG/POG/COG) increased 144% over this time, but the rate
of clinical trial enrollment for established patients decreased from
32% in 1981-1985 to 20% for the period ending in 2020, after a peak of
42% in 1986-1990, for an APC of -8.91% (95% CI of -13.3 to -4.3%)
(see Figure 6).