Search

This study, originating in the Automated Childhood Cancer Information System (ACCIS), evaluated the time trend in survival after childhood cancer in Europe. The study included more than 72,000 childhood cancer cases aged 0-14 years diagnosed in 1978-1997 and followed-up in 30 population-based cancer registries with a long history of registration and follow-up, in 15 European countries. Survival was analysed using an actuarial life-table method. Five-year cumulative survival probability increased significantly over the study period for all tumour types combined, from 54% for cases diagnosed in the period 1978-1982 to 75% in 1993-1997. Significant improvement was also observed in 10-year survival. Comparing the results for the period 1993-1997 with those for 1978-1982, the largest relative increase in survival was seen for hepatic tumours (32%) and the largest reduction in mortality for non-Hodgkin's lymphomas (60%). Least progress was seen for central nervous system (CNS) tumours. The improvement was statistically significant in all European regions and was most rapid in the East. The ranking among the European regions did not change over the study period, with highest survival in the North and the West and lowest in the East. Extended data collection is necessary to evaluate future time trends and changes in differences between European regions. [ABSTRACT FROM AUTHOR]

Tertiary care centres, grouped in the Italian Association of Paediatric Haematology and Oncology (AIEOP) are unevenly distributed across the country. In an attempt to describe their perceived efficacy, we matched the residence and the location of the treatment centre in 18,441 patients aged less-than-or-equals, slant15 years treated in the AIEOP network between 1989 and 2005.Overall, centres located in the central and southern regions were less appealing than those located in the North, although this trend decreased over the study period. Patients with solid tumours migrated more frequently than those with leukaemia or lymphoma.Information resulting from better knowledge of the non-random migrations for treatment of children with cancer will be useful to refine planning of the national paediatric haematology-oncology network with social and economic implications. [ABSTRACT FROM AUTHOR]

We describe the survival patterns of 10,791 Italian children (age 0-14) diagnosed with cancer during 1989-1998 and who were included in the hospital-based registry of the Italian Association of Paediatric Haematology and Oncology. Five-year cumulative survival percentages were 76% for lymphoproliferative disorders and 68% for solid tumours. Survival rates in 1994-1998 significantly improved for acute lymphocytic leukaemia (ALL), acute non-lymphocytic leukaemia, Hodgkin's lymphoma and Wilms' tumour. Gender and age were determinants of survival for some specific types of cancer. Girls with ALL and neuroblastoma exhibited a significant advantage (hazard ratio HR 0.72, 0.62-0.83) and disadvantage (HR 0.73, 0.59-0.90) over boys, respectively. Children with a Wilms' tumour diagnosed above age 3 had a worse prognosis than younger children (HR 2.3, 1.4-4.1). The persisting gender-related difference in survival rate for ALL requires understanding as to whether it is attributable to delays in the adoption of more recent therapeutic protocols, while the corresponding findings for Wilms' tumour and neuroblastoma deserve further biological interpretation. [ABSTRACT FROM AUTHOR]

Within the framework of the Automated Childhood Cancer Information System (ACCIS), time trend analyses for childhood cancer were performed using data from 33 population-based cancer registries in 15 European countries for the period 1978-1997. The overall incidence rate based on 77,111 cases has increased significantly (P<0.0001), with an average annual percentage change (AAPC) of 1.1%. The rising trend was observed in all five geographical regions and in the majority of the disease groups (in order of AAPC): soft tissue sarcomas (1.8%), brain tumours, tumours of the sympathetic nervous system, germ-cell tumours, carcinomas, lymphomas, renal tumours, and leukaemias (0.6%). No change was seen in incidence of bone tumours, hepatic tumours and retinoblastoma. The increased incidence can only partly be explained by changes in diagnostic methods and by registration artefacts. The patterns and magnitude of these increases suggest that other factors, e.g. changes in lifestyle and in exposure to a variety of agents, have contributed to the increase in childhood cancer in the recent decades. [ABSTRACT FROM AUTHOR]