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. 2017 Sep 15;66(36):950–954. doi: 10.15585/mmwr.mm6636a3

TABLE. Age-adjusted incidence* of acute lymphoblastic leukemia in persons aged <20 years and annual percentage change (APC) in rates, by selected characteristics — United States,§ 2001–2014.

Characteristic No. Incidence (95% CI) APC
Years APC1 (95% CI) Years APC2 (95% CI) Years APC3 (95% CI)
Overall
38,136
34.0 (33.6–34.3)
2001–2008
1.9 (0.5–3.3)**
2008–2014
-1.1 (-2.8–0.6)
††

Sex
Male
21,871
38.0 (37.5–38.5)
2001–2008
2.1 (0.5–3.7)**
2008–2014
-1.5 (-3.3–0.4)


Female
16,265
29.7 (29.2–30.1)
2001–2003
-4.0 (-14.7–8.1)
2003–2008
3.2 (-0.5–7.0)
2008–2014
-1.0 (-2.9–0.9)
Age group (yrs)
<1
1,009
18.4 (17.3–19.6)
2001–2014
-1.5 (-3.3–0.3)
††



1–4
16,388
75.2 (74.0–76.4)
2001–2009
1.3 (-0.1–2.8)
2009–2014
-2.4 (-5.2–0.5)


5–9
9,535
34.8 (34.1–35.5)
2001–2010
2.2 (1.3–3.2)**
2010–2014
-1.7 (-4.6–1.3)


10–14
6,201
21.6 (21.1–22.1)
2001–2014
1.3 (0.5–2.1)**




15–19
5,003
17.0 (16.5–17.5)
2001–2014
0.4 (-0.5–1.3)




Race/Ethnicity§§
White
21,843
34.2 (33.8–34.7)
2001–2014
0.3 (-0.3–0.9)




Black
3,129
18.7 (18.0–19.3)
2001–2014
1.2 (-0.1–2.7)




Hispanic
10,595
42.9 (42.1–43.7)
2001–2008
2.5 (0.3–4.7)**
2008–2014
-1.8 (-4.2–0.6)


American Indian/Alaska Native
350
30.2 (27.1–33.6)
2001–2014
-1.9 (-4.2–0.5)




Asian/Pacific Islander
1,765
31.6 (30.1–33.1)
2001–2014
0.3 (-0.9–1.6)




U.S. Census region¶¶
Northeast
—***
34.8 (34.0–35.6)
2001–2007
3.0 (0.2–6.0)**
2007–2014
-1.6 (-3.7–0.7)


Midwest

32.4 (31.7–33.2)
2001–2011
1.6 (0.6–2.6)**
2011–2014
-5.4 (-11.4–1.0)


South

31.6 (31.0–32.1)
2001–2003
-4.6 (-15.3–7.6)
2003–2008
3.9 (0.2–7.7)**
2008–2014
-1.3 (-3.2–0.5)
West

38.5 (37.8–39.3)
2001–2014
0.4 (-0.3–1.1)




County-level economic status by percentile (%)
Bottom 25
4,182
32.2 (31.2–33.2)
2001–2014
1.4 (0.6–2.2)**




25–75
22,141
33.9 (33.4–34.3)
2001–2010
1.1 (0.2–2.1)**
2010–2014
-2.4 (-5.5–0.9)


Top 25
10,646
34.9 (34.2–35.6)
2001–2008
2.9 (0.7–5.1)**
2008–2014
-1.5 (-4.0–1.1)


Urban/Rural status
Metropolitan area ≥1 million population
21,690
35.7 (35.3–36.2)
2001–2008
2.7 (1.2–4.2)**
2008–2014
-1.6 (-3.4–0.2)


Metropolitan area 250,000 to <1 million population
8,134
34.4 (33.7–35.2)
2001–2011
0.8 (-0.4–2.1)
2011–2014
-4.4 (-11.8–3.7)


Metropolitan area <250,000 population
3,302
33.8 (32.7–35.0)
2001–2014
0.6 (-0.3–1.5)




Nonmetropolitan counties 4,962 32.9 (32.0–33.9) 2001–2014 0.9 (0.0–1.8)

Source: CDC’s National Program of Cancer Registries and the National Cancer Institute’s Surveillance, Epidemiology, and End Results program.

Abbreviation: CI = confidence interval.

* Per 1 million persons, age-adjusted to the 2000 U.S. standard population.

Cases included International Classification of Diseases for Oncology, Third Edition codes (9728–9729, 9811–9818, 9835–9837) as grouped by the International Classification of Childhood Cancer.

§ Incidence data are compiled from cancer registries that meet the data quality criteria for all years during 2001–2014 (covering approximately 98% of the U.S. population). Registry-specific data quality information is available at https://www.cdc.gov/cancer/npcr/uscs/data/00_data_quality.htm. Characteristic values with unknown, other, missing, or blank results are not included in this table.

Trends were measured with APC in rates and were considered to increase or decrease if p<0.05; otherwise trends were considered stable. Trends were calculated using joinpoint regression, which allowed for different slopes in as many as three different periods, represented by APC1, APC2, and APC3, as applicable. The duration in years of APC1, APC2, and APC3 varied by study characteristic depending on joinpoint regression calculation. APC was not calculated if case count was <16 cases in any 1 year.

** p<0.05.

†† Trend adequately described during 20012014 by previous APC columns.

§§ White, black, American Indian/Alaska Native, and Asian/Pacific Islander persons are non-Hispanic. Hispanic persons might be of any race.

¶¶ Midwest: Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, and Wisconsin. Northeast: Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, and Vermont. South: Alabama, Arkansas, Delaware, District of Columbia, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, and West Virginia. West: Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, and Wyoming.

*** Number counts suppressed per United States Cancer Statistics complementary cell suppression rules: counts for national and regional data must be suppressed if a single state in a region or division is suppressed.