Epidemiological surveillance of childhood and adolescent malignancies as a tool for public health strategy: insights from the Polish National Cancer Registry 2023

Abstract

Background Pediatric malignancies require specialized epidemiological surveillance due to their distinct developmental etiology and unique societal impact. In the context of contemporary European demographic trends, characterized by sub-replacement fertility, monitoring health outcomes in younger cohorts has become a strategic public health priority. Methods This population-based retrospective analysis evaluates the incidence and epidemiological patterns of childhood and adolescent malignancies in Poland in 2023, utilizing Polish National Cancer Registry (PNCR) data to provide an evidence base for health policy optimization. Results Among the 1,229 new cases recorded (782 in the 0–14 cohort), a bimodal age distribution peaked at 0–4 and 15–19 years. While the aggregate gender burden was balanced [Incidence Rate Ratio (IRR) = 1.01], significant biological disparities occurred in specific subtypes, notably a marked female predominance in thyroid carcinoma and an extreme male predilection in Burkitt lymphoma (IRR = 10.43 in the 0–14 group). Descriptive long-term trend analysis suggests an upward trajectory in incidence, with an observed localized peak in 2021–2022. Discussion Given current demographic constraints, with Poland's fertility rate (1.2) significantly below the EU average, these malignancies represent a disproportionate loss of future human capital. Our findings underscore that pediatric oncological care is a high-efficiency investment with a substantial social return. We advocate for the establishment of a dedicated pediatric registry integrated with molecular-genetic data, which is essential for the transition toward precision oncology and the strategic allocation of resources to mitigate the long-term socio-economic impact of these malignancies on the population.