Prevalence of hypercalcemia of malignancy among pediatric cancer patients in the UK Clinical Practice Research Datalink database

Abstract

Background

The reported proportion of cancer patients who experience hypercalcemia of malignancy (HCM) is low, particularly in the pediatric population, ranging between <1% and 5%. HCM can be observed with any type of tumor in children and occurs most commonly with leukemia. While HCM is a potentially fatal condition, the prevalence of HCM is not well understood in pediatric cancer patients.

Methods

Using the UK Clinical Practice Research Datalink, we identified pediatric cancer patients with recorded corrected serum calcium (CSC) from 2003 through 2014. Hypercalcemic patients (CSC ≥10.8 mg/dL) were classified into 4 CSC levels. We estimated the annual prevalence of HCM using Byar’s method.

Results

Among 517 pediatric cancer patients, leukemia, lymphoma, and brain tumors were the most frequent cancer types. The prevalence of HCM overall (grade 1 or higher) ranged from 0.24% to 0.81% between 2003 and 2014. There were too few cases to compare prevalence by type of cancer.

Conclusion

We provide the first systematic analysis using a UK population-based data source to estimate the number of pediatric cancer patients affected with HCM by grade. Our findings showed that the prevalence of pediatric HCM was very low (0.24%–0.81%) over the 12-year study period, which is consistent with previous study of adult cancer patients in the UK (0.20%–0.67%).

Keywords:

• hypercalcemia
• pediatric
• cancer
• prevalence
• Clinical Practice Research Datalink

Author contributions

S Jick participated in the conception and design of the study, and contributed to data analysis. L Li contributed to study design and conducted the analyses. VM Gastanaga, A Liede, and RK Hernandez participated in the conception and design of the study, and contributed to data analysis and interpretation. All the authors participated in revisions of the manuscript for intellectual content. S Jick is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. All the authors contributed to study concept, design, and interpretation, manuscript preparation, critical editing, and review, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

This study was funded by Amgen Inc. The coauthors VMG, AL, and RKH are employees of Amgen Inc. The authors report no other conflicts of interest in this work.