Evolution and Distribution of Childhood Leukemia Mortality in Greece: Etiological Implications

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Abstract
The purpose of this study was to examine regional and temporal trends of childhood (0–14 years) mortality from leukemia in Greece and to explore whether there was any evidence of excess mortality or place clustering of childhood leukemia deaths in the Greek island populations. Over a 14-year period (1976–1989) for which adequate information by place of residence was available, 679 deaths from childhood leukemia were registered in Greece. After standardization and application of multiple regression procedures, it was found that mortality from childhood leukemia in Greece declined over the study period by about 70%, with no evidence of differential reduction by gender, age, or population type (urban, non-urban). In the two of the nine geographical regions of Greece that comprise exclusively island populations of small to modest size, mortality rates were not significantly higher and slopes of decline over time were substantially steeper. These findings provide no support to Kinlen's hypothesis that population groups who were relatively isolated in the past, but have recently received a large influx of newcomers (due, in this instance, to tourism) may experience an increase in the incidence of childhood leukemia, because of changes in herd immunity. Furthermore, there was no evidence of heterogeneity of mortality from childhood leukemia among 13 island counties (nomoi) even though heterogeneity might have been expected on account of the different time patterns of tourist development in the respective island counties.

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