Temporal trends in childhood cancer survival in Egypt, 2007 to 2017: A large retrospective study of 14 808 children with cancer from the Children's Cancer Hospital Egypt

Childhood cancer is a priority in Egypt due to large numbers of children with cancer, sub-optimal care and insufficient resources. It is difficult to evaluate progress in survival due to paucity of data in national cancer registry. In this study, we studied survival rates and trends in survival of the largest available cohort of children with cancer (n=15,779, aged 0-18 years) from Egypt between 2007-2017, treated at Children's Cancer Hospital Egypt-(CCHE), representing 40-50% of all childhood cancers across Egypt. We estimated 5-year overall survival (OS) for 14,808 eligible patients using Kaplan Meier method, and determined survival trends using Cox regression by single year of diagnosis, and diagnosis periods. We compared age-standardized rates to international benchmarks in England and the US, identified cancers with inferior survival, and provided recommendations for improvement. Five-year OS was 72.1% (95% CI 71.3-72.9) for all cancers combined, and survival trends increased significantly by single year of diagnosis (p