Trends in neuroblastoma in Great Britain: incidence and mortality, 1971-1990.

Incidence and mortality rates for neuroblastoma in Britain from 1971 onwards were examined using data from the population-based National Registry of Childhood Tumours. Incidence throughout 1971-1990 was within the range previously reported from Europe, North America and Oceania. The age-standardised rate rose, however, by 26% between 1971-1975 and 1986-1990, and there were increases of 36% both among infants aged under one year and also among children aged 1-9. There was a pattern of increasing risk with more recent years of birth up to 1985. It is implausible that improved diagnosis could explain the increase in rates since 1971, though it may account for a marked decrease in recorded incidence at the age of 10-14. Age-standardised mortality fell by 27% between 1971-1975 and 1981-1985, but rose again during 1986-1990. This was the result of a halt in the improvement in survival rates for neuroblastoma combined with a substantial and as yet unexplained increase in incidence.