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A Sunnier Forecast But Still Some Clouds: Trends in Pediatric Cancer Care in Florida from 1981-2020
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  • Peter Shaw,
  • Jonathan Metts,
  • Ernest Amankwah,
  • Don Eslin,
  • Scott Bradfield ,
  • William Slayton,
  • Brian Hays ,
  • Brian Calkins ,
  • Craig MacArthur,
  • Juan Rico,
  • Julio Barredo,
  • Amy Smith,
  • Iftikhar Hanif,
  • Hector Rodriguez-Cortes,
  • Ramamoorthy Nagasubramanian,
  • Jeffrey Krischer
Peter Shaw
All Children's Hospital

Corresponding Author:[email protected]

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Jonathan Metts
Johns Hopkins All Children's Hospital
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Ernest Amankwah
Johns Hopkins University
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Don Eslin
Saint Joseph's Children's Hospital
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Scott Bradfield
Nemours Children's Health System
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William Slayton
University of Florida
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Brian Hays
University of South Florida
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Brian Calkins
University of South Florida
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Craig MacArthur
Golisano Children's Hospital of Southwest Florida
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Juan Rico
University of South Florida
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Julio Barredo
University of Miami
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Amy Smith
Arnold Palmer Hospital for Children
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Iftikhar Hanif
Joe DiMaggio Children's Hospital
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Hector Rodriguez-Cortes
Broward General Medical Center
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Ramamoorthy Nagasubramanian
Nemours Children\'s Clinic
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Jeffrey Krischer
University of South Florida
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Background: The Florida Association of Pediatric Tumor Programs (FAPTP) has used the Statewide Patient Information Reporting System (SPIRS) since 1980 to track all cases of pediatric cancer. We reviewed the last 40 years of SPIRS data to see how pediatric cancer care has evolved. Methods: We retrospectively analyzed the SPIRS data from 1980 through 2020 in 5-year increments, looking at numbers of new diagnoses, care delivery sites and trial enrollment in Children’s Oncology Group (COG) studies. Results: From 1981-2020 Florida’s population increased almost 88% while the pediatric population only grew 61%. New pediatric cancer diagnoses increased 326% to over 1,000 new cases/year with the median age increasing from 6 to 9. The percentage of patients treated at FAPTP centers grew from 30% to 57% with an annual percentage change (APC) of 10.3% (95% Confidence Interval [CI] of 0.6 to 20.9%) and those with known follow-up rose from 65% to 94%, an APC of 4.5% (95% CI of 3 to 6%). The rate of COG clinical trial enrollment decreased from 32% in 1981-1985 to 20% from 2016-2020, for an APC of 8.91% (95% CI of -13.3 to -4.3%). Conclusions: The striking increase in pediatric cancer cases in Florida over the last 40 years was out of proportion to the population growth. More patients received care at FAPTP centers but a lower percentage were enrolled on COG clinical trials. Improved access to care has not translated into a higher rates of trial enrollment, a deficit which merits further investigation and initiatives.