Geographical comparison of cancer survival in European children (1988–1997): Report from the Automated Childhood Cancer Information System project

doi:10.1016/j.ejca.2006.05.013

European Journal of Cancer

Volume 42, Issue 13, September 2006, Pages 1972-1980

https://doi.org/10.1016/j.ejca.2006.05.013 Get rights and content

Abstract

The aim of this study was to assess regional survival differences among childhood cancer patients in Europe. For this exercise, the Automated Childhood Cancer Information System (ACCIS) database was utilised. Survival data from 54 population-based cancer registries on 49,651 childhood cancer patients aged 0–14 years and diagnosed in 1988–1997 were analysed using life-table method. Overall, the 5-year survival was 72% among all patients, varying from 62% to 77% between the five geographical regions. The East region generally had lower survival rates than the rest of Europe. The geographical differences indicate the need for more co-ordination, systematisation and standardisation in diagnosis, referral and the treatment of childhood cancers in Europe. Increase of resources is necessary to improve the lower survival in the East region. Continuing data collection on a European level will facilitate monitoring of population-based survival of childhood cancer patients.

Introduction

Survival of children with cancer has improved considerably over the last decades in the developed countries worldwide. However, large differences were observed within Europe for children diagnosed over the period 1978–1992, which are also reflected in differences in mortality statistics.1, 2 In 1985–1989, 5-year survival for all childhood cancers combined varied from 55% to 77% between regions in Europe.¹

The Automated Childhood Cancer Information System (ACCIS) is a collaborative project of the European cancer registries, aiming at collection, presentation and interpretation of data on cancer incidence and survival of children and adolescents in Europe.³

The ACCIS database contains data from 78 population-based cancer registries that cover about 50% of the population aged 0–14 years and about 25% of the population aged 15–19 years living in the 35 participating countries. It covers 1.3 billion person-years, giving rise to over 160,000 cases of childhood and adolescent cancer diagnosed during the period 1968–2001.

Using the ACCIS database, we aim to extend the general information on survival of children with cancer in Europe, describe the geographical differences, estimate their extent and discuss their possible reasons.

Section snippets

Patients and methods

All malignant neoplasms, together with non-malignant tumours of the central nervous system (CNS), registered between 1988 and 1997 in patients aged less than 15 years in the participating registries listed in Table 1 were extracted from the ACCIS database.

A standard set of variables included basic demographic data (age, sex, country or region of residence), information on the tumour (date of incidence, site, morphology and basis of diagnosis) and on follow-up (date of last contact and vital

Results

In the period 1988–1997, the overall observed 5-year survival among the 49,651 childhood cancer patients across Europe was 72% (Table 2). It varied between 77% in the North and 62% in the East. It was 71% in the British Isles, 72% in the South and 75% in the West (Table 2, Fig. 1). The survival curves tested by log-rank test were significantly different between the pairs of regions with neighbouring ranks, with the exception of the survival curves for the British Isles and the South (χ² = 1.6, P =

Discussion

This paper addresses the geographical differences in survival of childhood cancer patients in the different regions of Europe. The detailed description of the patient materials is given in a separate article in this Special Issue [Steliarova-Foucher, Kaatsch, Lacour and colleagues, this issue]. As pointed out in the Methods section, the use of observed survival rather than relative survival was justified, as we were able to estimate the negligible error of the unadjusted survival proportions

Conflict of interest statement

None declared.

Acknowledgements

The ACCIS project was funded by the European Commission from ‘Europe Against Cancer’ action programme (1996–2002) (contracts SI2.126875, SI2.321970 and SPC.2002303), jointly with International Agency for Research on Cancer (IARC). Data analyses were partly financed by the French Ligue National Contre le Cancer, Comité du Rhône. The Childhood Cancer Research Group receives funding from the Department of Health and the Scottish Ministers. The views expressed in the publication are those of the

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Geographical comparison of cancer survival in European children (1988–1997): Report from the Automated Childhood Cancer Information System project

Abstract

Introduction

Section snippets

Patients and methods

Results

Discussion

Conflict of interest statement

Acknowledgements

Eur J Cancer

Eur J Cancer

Ann Oncol

Eur J Cancer

Geographical patterns and time trends of cancer incidence and survival among children and adolescents in Europe since 1970s: the ACCIS project

Lancet

Calculations of survival rates for cancer

Proc Staff Meet Mayo Clin