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Source
Ann Oncol. 2003;14 Suppl 5:v119-27
Publication Type
Article
Date
2003
Author
G. Gatta
I. Corazziari
C. Magnani
R. Peris-Bonet
P. Roazzi
C. Stiller
Author Affiliation
Epidemiology Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy. gatta@istitutotumori.mi.it
Source
Ann Oncol. 2003;14 Suppl 5:v119-27
Date
2003
Language
English
Publication Type
Article
Keywords
Adolescent
Age Factors
Child
Child, Preschool
Europe - epidemiology
Female
Humans
Male
Neoplasms - epidemiology - mortality
Research Support, Non-U.S. Gov't
Survival Analysis
Survival Rate
Abstract
BACKGROUND: EUROCARE-3 collected data from 45 population-based cancer registries in 20 countries on 24 620 European children aged from 0 to 14 years diagnosed with malignancy in the period 1990-1994. METHODS: Five-year survival between countries was compared for all malignancies and for the major diagnostic categories, adjusting for age, and estimated average European survival weighting for differences in childhood populations. RESULTS: For all cancers combined, survival variation was large (45% in Estonia to 90% in Iceland), and was generally low (60-70%) in eastern Europe and high (> or =75%) in Switzerland, Germany and the Nordic countries (except Denmark). The Nordic countries had the highest survival for four of the seven major tumour types: nephroblastoma (92%), acute lymphoid leukaemia (85%), CNS tumours (73%) and acute non-lymphocytic leukaemia (62%). The eastern countries had lowest survival: 89% for Hodgkin's disease, 71% for nephroblastoma, 68% for acute lymphoid leukaemia, 61% for non-Hodgkin's lymphoma, 57% for central nervous system (CNS) tumours and 29% for acute non-lymphocytic leukaemia. CONCLUSIONS: The Nordic countries represent a survival gold standard to which other countries can aspire. Since most childhood cancers respond well to treatment, survival differences are attributable to differences in access (including referral and timely diagnosis) and use of modern treatments; however, the obstacles to access and application of standard treatments probably vary markedly with country.
PubMed ID
14684502 View in PubMed
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Variation in survival of European children with acute lymphoblastic leukaemia, diagnosed in 1978--1992: the EUROCARE study.

https://arctichealth.org/en/permalink/ahliterature19869
Source
Eur J Cancer. 2001 Apr;37(6):687-94
Publication Type
Article
Date
Apr-2001
Author
J W Coebergh
G. Pastore
G. Gatta
I. Corazziari
W. Kamps
Author Affiliation
Dutch Childhood Leukaemia Study Group, PO Box 43515, 2504 AM, The Hague, The Netherlands. coebergh@wxs.nl
Source
Eur J Cancer. 2001 Apr;37(6):687-94
Date
Apr-2001
Language
English
Publication Type
Article
Keywords
Adolescent
Age Distribution
Child
Child, Preschool
Europe - epidemiology
Female
Humans
Infant
Infant, Newborn
Leukemia, Lymphocytic, Acute, L1 - mortality
Male
Registries
Research Support, Non-U.S. Gov't
Residence Characteristics
Sex Distribution
Survival Analysis
Survival Rate - trends
Abstract
The aim of this study was to provide a comparative description of geographical variations and time trends in the population-based survival of European children with acute lymphoblastic leukaemia (ALL). Data on 13344 newly diagnosed children (0--14 years) with ALL were included in the EUROCARE study and were collected were collected by 34 population-based cancer registries (four comprising only childhood malignancies), operating in 17 countries (four in Scandinavia, two in Southern Europe, three in Eastern Europe, six in Continental Europe and two in the UK). Age-specific crude survival rates were estimated for boys and girls according to country for the period 1985--1989 and in adjusted form to attain comparability. Overall pooled and weighted rates were estimated as European standards. Children dead at diagnosis or diagnosed only through a death certificate were excluded. Geographical variation was also estimated by calculating the relative death rate with respect to the pooled overall European rate. After adjustment for age, gender and country, a Cox regression analysis was used to estimate time trends in survival. Survival was compared with that in the USA, Japan, Canada and Australia. During 1985--1989, the 1-year survival rate varied from 99 to 79%, the 5-year survival rate from over 80 to 56% (with the exception of Estonia; 34%; 95% confidence interval (CI) 20--52) among the various countries; the European weighted means were 90 (95% CI 87--93) and 72% (95% CI 69--75), respectively. Survival was particularly favourable in (south) Sweden, Finland, Germany and The Netherlands and rather unfavourable in Estonia and (surprisingly) France, where only 4% of its population was covered by the participating registries. Compared with the period 1978--1981, the hazard ratio for the period 1986--1989 decreased to 0.59 (95% CI 0.54--0.64) and -- in a smaller set of registries -- to 0.49 (0.45--0.55) for 1990-1992, an annual decrease in this rate of approximately 3.5%. During 1985--1989, the 5-year survival rates for European children were largely similar to those found in the USA, Canada and Australia, but markedly better than those in Japan. Higher survival rates were found for countries with 'good' access to centrally organised diagnostic and treatment facilities which stimulated 'aggressive' treatments according to a protocol. However, a subdivision according to risk profiles, e.g. according to the initial white blood cell count at diagnosis, could not be made and this might have explained partially the geographical differences in survival, because a positive association appeared between incidence at age 1--4 years and 5-year survival in most countries.
PubMed ID
11311642 View in PubMed
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