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).