Recent trends in childhood cancer mortality rates---west census region of U.S., 1990-2003

West is a U.S. Census region with the highest death rate from childhood cancers. A recent study indicated a slight increase in the death rate in the West during 1996-2003; however, this change has not been well characterized. Thus, we examined which group accounted for this increase. The most recent National Vital Statistics System mortality data were used to identify childhood cancer deaths in the West between 1990 and 2003. Age-adjusted death rates (ADR) per million were calculated and stratified by sex, age, race/ethnicity and cancer site. Trend changes per year were assessed by Joinpoint regression. We identified 7,813 deaths from all childhood cancers in the West (ADR=31.30). The ADR significantly declined among females during 1990-2003 (-1.21%); it significantly declined among males during 1990-1999 (-3.20%), but increased during 1999-2003 (3.76%). The ADR slightly declined for Blacks (-1.76%), Asians/Pacific Islanders (-1.52%), and American Indians/Alaska Natives (-1.79%) during 1990-2003; for Whites it significantly declined during 1990-1999 (-2.84%), but increased during 1999-2003 (3.36%). The ADR significantly declined for Non-Hispanics during 1990-2003 (-1.77%); it declined for Hispanics during 1992-1998 (-3.10%), but increased during 1998-2003 (3.71%) especially a significant increase occurring among children aged 0-14 years (3.13%). Only decreasing or stable trends were observed for leukemia (-2.34%), lymphoma (-6.00%) and brain tumor (-0.18%) during 1990-2003. This study demonstrates substantial variability in death rate for childhood cancer by year and by demographic factors. It suggests the recent increase of ADR in the West might be partially attributed to the rate increasing among young white Hispanic males.