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Childhood Cancer Survival Trends in Europe: A EUROCARE Working Group Study

From the Epidemiology Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori; Pediatric Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan; Laboratory of Epidemiology, Istituto Superiore di Sanità, Rome, Italy; Childhood Cancer Research Group, University of Oxford, Oxford, United Kingdom; and Institute for Medical Biostatistics, Epidemiology and Informatics, German Childhood Cancer Registry, University Mainz, Mainz, Germany

Address reprint requests to Gemma Gatta, MD, Epidemiology Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, Via Venezian 1, 20133 Milano, Italy; e-mail: gatta{at}istitutotumori.mi.it

PURPOSE: EUROCARE collected data from population-based cancer registries in 20 European countries. We used this data to compare childhood cancer survival time trends in Europe.

PATIENTS AND METHODS: Survival in 44,129 children diagnosed under the age of 15 years during 1983 to 1994 was analyzed. Sex- and age-adjusted 5-year survival trends for 10 common cancers and for all cancers combined were estimated for five regions (West Germany, the United Kingdom, Eastern Europe, Nordic countries, and West and South Europe) and Europe as a whole. Europe-wide trends for 14 rare cancers were estimated.

RESULTS: For all cancers combined, 5-year survival increased from 65% for diagnoses in 1983 to 1985 to 75% in 1992 to 1994. Survival improved for all individual cancers except melanoma, osteosarcoma, and thyroid carcinoma; although for retinoblastoma, chondrosarcoma, and fibrosarcoma, improvements were not significant. The most marked improvements (50% to 66%) occurred in Eastern Europe. For common cancers, the greatest improvements were for leukemia and lymphomas, with risk of dying reducing significantly by 5% to 6% per year. Survival for CNS tumors improved significantly from 57% to 65%, with risk reducing by 3% per year. Risk reduced by 4% per year for neuroblastoma and 3% per year for Wilms’ tumor and rhabdomyosarcoma. The survival gap between regions reduced over the period, particularly for acute nonlymphocytic leukemia, CNS tumors, and rhabdomyosarcoma. For rare Burkitt’s lymphoma, hepatoblastoma, gonadal germ cell tumors, and nasopharyngeal carcinoma, risk reductions were at least 10% per year.

CONCLUSION: These gratifying improvements in survival can often be plausibly related to advances in treatment. The prevalence of European adults with a history of childhood cancer will inevitably increase.

Supported by the EUROCARE-3 BIOMED-2 Programme Contract No. BMH4-CT98–3390 and the Compagnia di San Paolo, Torino, Italy; the United Kingdom Childhood Cancer Research Group has been supported by the Department of Health and Scottish Ministers of the United Kingdom.

The views expressed in this article are those of the authors and not necessarily those of the Department of Health and Scottish Ministers.

Authors’ disclosures of potential conflicts of interest are found at the end of this article.

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