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Desandes E, Lapouble E, Lacour B, Guissou S, Goujon S, Defachelles AS, Marechal V, Gaspar N, Gomez-Mascard A, Karanian M, Marec-Berard P, Minard-Colin V, Orbach D, Tabone MD, Delattre O, Pierron G. Impact of age on survival according to molecular tumor findings in children and adolescents with soft-tissue and bone sarcoma: The BIOSCA project. Cancer Epidemiol 2024; 92:102398. [PMID: 37357067 DOI: 10.1016/j.canep.2023.102398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/05/2023] [Accepted: 06/09/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND Adolescents (15-19 years) with sarcoma are known to have significantly worse survival than children (0-14 years). One possible reason may be that the adolescent sarcomas exhibit specific biological characteristics resulting in differences in clinical presentation and treatment resistance behaviors. The BIOSCA project aims to further explore these age-related differences in survival accounting for molecular tumor characteristic in children and adolescents with sarcoma. METHODS A retrospective national population-based observational study with documented somatic genetic analyses was conducted between 2011 and 2016 of all patients aged from 0 to 17 years with a diagnosis of sarcoma using the National Registry of Childhood Cancers Database. RESULTS A total of 1637 children (0-9years: 40%), preadolescents (10-14years: 35%) and adolescents (15-17 years: 25%) with a diagnosis of bone (N = 845) or soft-tissue (N = 792) sarcoma were included. Adolescents had significantly worse outcome for undifferentiated small round cell sarcoma (USRCS), alveolar rhabdomyosarcoma (ARMS), and epithelioid sarcoma. Five-year overall survivals were worse among CIC-rearranged USRCS cases (47% [95%CI:21-69]) as compared to other USRCS, and PAX3::FOXO1 ARMS patients (44% [95%CI:32-55]) as compared to other ARMS. Adjusting for stage and genomic-profiling status, adolescents with USRCS were 1.6-fold more likely to die than children (P = 0.05), while the difference in survival between age of ARMS patients was weaken. Indeed, the prevalence of PAX3::FOXO1 increased significantly with age. CONCLUSION Age was an independent prognostic factor of outcome only in patients with USRCS, while the association between age and survival of patients with ARMS could be partly explained by differences in prevalence of PAX3::FOXO1.
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Affiliation(s)
- Emmanuel Desandes
- Registre National des cancers de l'Enfant, Registre National des Tumeurs Solides de l'Enfant, CHRU Nancy, Vandœuvre-lès-Nancy, France; Epidemiology of childhood and adolescent cancers, CRESS, INSERM, UMR1153, Université Paris-Cité, Paris, France.
| | - Eve Lapouble
- Unité de Génétique Somatique, Département de génétique, Institut Curie, Paris, France
| | - Brigitte Lacour
- Registre National des cancers de l'Enfant, Registre National des Tumeurs Solides de l'Enfant, CHRU Nancy, Vandœuvre-lès-Nancy, France; Epidemiology of childhood and adolescent cancers, CRESS, INSERM, UMR1153, Université Paris-Cité, Paris, France
| | - Sandra Guissou
- Registre National des cancers de l'Enfant, Registre National des Tumeurs Solides de l'Enfant, CHRU Nancy, Vandœuvre-lès-Nancy, France; Epidemiology of childhood and adolescent cancers, CRESS, INSERM, UMR1153, Université Paris-Cité, Paris, France
| | - Stéphanie Goujon
- Epidemiology of childhood and adolescent cancers, CRESS, INSERM, UMR1153, Université Paris-Cité, Paris, France; Registre National des Cancers de l'Enfant, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris (AP-HP), Villejuif, and Centre Hospitalier Régional Universitaire de Nancy, Vandœuvre-lès-Nancy, France
| | - Anne-Sophie Defachelles
- Department of Pediatric, Adolescents and Young Adults Oncology, Centre Oscar Lambret, Lille, France
| | - Valérie Marechal
- Unité de Génétique Somatique, Département de génétique, Institut Curie, Paris, France
| | - Nathalie Gaspar
- Department of Oncology for Child and Adolescent, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Anne Gomez-Mascard
- Laboratoire d'anatomie et cytologie pathologiques, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Marie Karanian
- Departments of Biopathology, Centre Léon Bérard, Lyon, France; Univ Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Cancer Research of Lyon, Lyon, France
| | - Perrine Marec-Berard
- Département d'hémato-oncologie pédiatrique, IHOPe/Centre Leon Berard, Lyon, France
| | - Véronique Minard-Colin
- Department of Oncology for Child and Adolescent, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Daniel Orbach
- SIREDO oncology center (Care, Innovation and Research for Children, Adolescents and young Adults with Cancer), Institut Curie, PSL University, Paris, France
| | - Marie-Dominique Tabone
- Department of Pediatric Hemato-Oncology, Armand-Trousseau Sorbonne University Hospital, AP-HP, Paris, France
| | - Olivier Delattre
- Unité de Génétique Somatique, Département de génétique, Institut Curie, Paris, France; INSERM U830, Diversity and Plasticity of Childhood Tumors Lab, PSL Research University, SIREDO Oncology Center, Institut Curie Research Center, Paris, France
| | - Gaelle Pierron
- Unité de Génétique Somatique, Département de génétique, Institut Curie, Paris, France
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Giusti F, Martos C, Carvalho RN, Zadnik V, Visser O, Bettio M, Van Eycken L. Facing further challenges in cancer data quality and harmonisation. Front Oncol 2024; 14:1438805. [PMID: 39119089 PMCID: PMC11307262 DOI: 10.3389/fonc.2024.1438805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2024] [Accepted: 07/01/2024] [Indexed: 08/10/2024] Open
Abstract
This article highlights the recent and ongoing activities of European population-based cancer registries (PBCRs) in data quality and harmonisation in the framework of the collaboration between the European Network of Cancer Registries (ENCR) and the Directorate-General Joint Research Centre (JRC), the science and knowledge centre of the European Commission. The article concludes the Frontiers in Oncology's Research Topic "Joining Efforts to Improve Data Quality and Harmonization Among European Population-Based Cancer Registries", which has been an opportunity for several European researchers to share their experience on cancer data quality and harmonisation. Such experience will be helpful for PBCRs in view of future challenges and opportunities in cancer epidemiology, with a few examples discussed in the present article.
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Affiliation(s)
- Francesco Giusti
- European Commission, Directorate General Joint Research Centre, Ispra, VA, Italy
- Belgian Cancer Registry, Brussels, Belgium
| | - Carmen Martos
- European Commission, Directorate General Joint Research Centre, Ispra, VA, Italy
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
| | - Raquel N. Carvalho
- European Commission, Directorate General Joint Research Centre, Ispra, VA, Italy
| | - Vesna Zadnik
- Slovenian Cancer Registry, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Otto Visser
- Department of Registration, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands
| | - Manola Bettio
- European Commission, Directorate General Joint Research Centre, Ispra, VA, Italy
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Forrest SJ, Gupta H, Ward A, Li YY, Doan D, Al-Ibraheemi A, Alexandrescu S, Bandopadhayay P, Shusterman S, Mullen EA, Collins NB, Chi SN, Wright KD, Kumari P, Mazor T, Ligon KL, Shivdasani P, Manam M, MacConaill LE, Ceca E, Benich SN, London WB, Schilsky RL, Bruinooge SS, Guidry Auvil JM, Cerami E, Rollins BJ, Meyerson ML, Lindeman NI, Johnson BE, Cherniack AD, Church AJ, Janeway KA. Molecular profiling of 888 pediatric tumors informs future precision trials and data-sharing initiatives in pediatric cancer. Nat Commun 2024; 15:5837. [PMID: 38992034 PMCID: PMC11239876 DOI: 10.1038/s41467-024-49944-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 06/18/2024] [Indexed: 07/13/2024] Open
Abstract
To inform clinical trial design and real-world precision pediatric oncology practice, we classified diagnoses, assessed the landscape of mutations, and identified genomic variants matching trials in a large unselected institutional cohort of solid tumors patients sequenced at Dana-Farber / Boston Children's Cancer and Blood Disorders Center. Tumors were sequenced with OncoPanel, a targeted next-generation DNA sequencing panel. Diagnoses were classified according to the International Classification of Diseases for Oncology (ICD-O-3.2). Over 6.5 years, 888 pediatric cancer patients with 95 distinct diagnoses had successful tumor sequencing. Overall, 33% (n = 289/888) of patients had at least 1 variant matching a precision oncology trial protocol, and 14% (41/289) were treated with molecularly targeted therapy. This study highlights opportunities to use genomic data from hospital-based sequencing performed either for research or clinical care to inform ongoing and future precision oncology clinical trials. Furthermore, the study results emphasize the importance of data sharing to define the genomic landscape and targeted treatment opportunities for the large group of rare pediatric cancers we encounter in clinical practice.
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Affiliation(s)
- Suzanne J Forrest
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
| | - Hersh Gupta
- Dana-Farber Cancer Institute, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Abigail Ward
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA
| | - Yvonne Y Li
- Dana-Farber Cancer Institute, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Duong Doan
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA
| | - Alyaa Al-Ibraheemi
- Harvard Medical School, Boston, MA, USA
- Boston Children's Hospital, Boston, MA, USA
| | - Sanda Alexandrescu
- Harvard Medical School, Boston, MA, USA
- Boston Children's Hospital, Boston, MA, USA
| | - Pratiti Bandopadhayay
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Suzanne Shusterman
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Elizabeth A Mullen
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Natalie B Collins
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Susan N Chi
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Karen D Wright
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | | | - Tali Mazor
- Dana-Farber Cancer Institute, Boston, MA, USA
| | - Keith L Ligon
- Harvard Medical School, Boston, MA, USA
- Dana-Farber Cancer Institute, Boston, MA, USA
- Boston Children's Hospital, Boston, MA, USA
- Brigham and Women's Hospital, Boston, MA, USA
| | | | | | | | - Evelina Ceca
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA
| | - Sidney N Benich
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA
| | - Wendy B London
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA
| | | | | | | | | | - Barrett J Rollins
- Harvard Medical School, Boston, MA, USA
- Dana-Farber Cancer Institute, Boston, MA, USA
- Brigham and Women's Hospital, Boston, MA, USA
| | - Matthew L Meyerson
- Harvard Medical School, Boston, MA, USA
- Dana-Farber Cancer Institute, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | | | - Bruce E Johnson
- Harvard Medical School, Boston, MA, USA
- Dana-Farber Cancer Institute, Boston, MA, USA
- Brigham and Women's Hospital, Boston, MA, USA
| | - Andrew D Cherniack
- Dana-Farber Cancer Institute, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Alanna J Church
- Harvard Medical School, Boston, MA, USA
- Boston Children's Hospital, Boston, MA, USA
| | - Katherine A Janeway
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
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Moreira DC, Garrido C, Rosado R, Girón V, Letona T, Morales G, Valverde P, Velásquez T, Alfaro J, Orellana E, Ortega MA, Salguero P, Fox Irwin L, Andujar A, de Alarcón PA, Luna-Fineman S, Manco-Johnson M, Conter V, Verna M, Canesi M, Massimino M, Spreafico F, Ferrari A, Gassant PY, Vásquez R, Friedrich P, Mack R, Ribeiro R, Metzger ML, Rodriguez-Galindo C, Antillón-Klussmann F. Impact of a Regional Pediatric Hematology/Oncology Fellowship Program in Guatemala. JCO Glob Oncol 2024; 10:e2300474. [PMID: 38870436 DOI: 10.1200/go.23.00474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/12/2024] [Accepted: 04/11/2024] [Indexed: 06/15/2024] Open
Abstract
PURPOSE This study aimed to describe and assess the regional experience of a pediatric hematology/oncology fellowship program based in Guatemala. METHODS The Unidad Nacional de Oncología Pediátrica (UNOP) in Guatemala City, Guatemala, is the only hospital in Central America dedicated exclusively to childhood and adolescent cancer. To address the regional need for specialists, a fellowship program in pediatric hematology/oncology was launched in 2003. The UNOP fellowship program comprises 3 years of training. Although the program is based at UNOP, it also includes rotations locally and internationally to enhance clinical exposure. The curriculum is based on international standards to cover clinical expertise, research, professionalism, communication, and health advocacy. Trainees are selected according to country or facility-level need for pediatric hematologists/oncologists, with a plan for them to be hired immediately after completing their training. RESULTS Forty physicians from 10 countries in Latin America have completed training. In addition, there are currently 13 fellows from five countries in training. Of the graduates, 39 (98%) are now practicing in pediatric hematology/oncology in Latin America. Moreover, many of them have leadership positions within their institutions and participate in research, advocacy, and policy making. Graduates from the UNOP program contribute to institutions by providing care for an increasing number of patients with pediatric cancer. The UNOP program is the first pediatric hematology/oncology fellowship program in the world to be accredited by Accreditation Council for Graduate Medical Education-International, an international body accrediting clinical training programs. CONCLUSION The UNOP program has trained specialists to increase the available care for children with cancer in Latin America. This regional approach to specialist training can maximize resources and serve as a model for other programs and regions.
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Affiliation(s)
| | - Claudia Garrido
- Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala
| | - Roy Rosado
- Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala
| | - Verónica Girón
- Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala
| | - Tomás Letona
- Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala
| | - Gerson Morales
- Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala
| | | | - Thelma Velásquez
- Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala
| | - Jeanine Alfaro
- Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala
| | - Elizabeth Orellana
- Laboratorio de Patología Dra. Elizabeth Orellana, Guatemala City, Guatemala
| | | | - Paola Salguero
- Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala
| | | | | | | | - Sandra Luna-Fineman
- Children's Hospital Colorado, School of Medicine, University of Colorado, Aurora, IL
| | - Marilyn Manco-Johnson
- Pediatric Hematology/Oncology/SCT, University of Colorado Anschutz Medical Center, Aurora, IL
| | - Valentino Conter
- Hemophilia and Thrombosis Center, University of Colorado Anschutz Medical Center, Aurora, IL
| | - Marta Verna
- Tettamanti Center, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Marta Canesi
- Tettamanti Center, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Maura Massimino
- Pediatrics, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | | | - Andrea Ferrari
- Pediatrics, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | | | | | | | - Ricardo Mack
- Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala
- Hospital Nacional de Niños Benjamin Bloom, San Salvador, El Salvador
| | - Raul Ribeiro
- St Jude Children's Research Hospital, Memphis, TN
| | | | | | - Federico Antillón-Klussmann
- Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala
- Hospital Nacional de Niños Benjamin Bloom, San Salvador, El Salvador
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5
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Michalek IM, Martos C, Caetano Dos Santos FL, Giusti F, Degerlund H, Neamtiu L, Taraszkiewicz L, Van Eycken L, Visser O. Advancing data collection and analysis: 2023 revised European Network of Cancer Registries recommendations for standard dataset. Eur J Cancer 2024; 199:113557. [PMID: 38281372 DOI: 10.1016/j.ejca.2024.113557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 01/07/2024] [Accepted: 01/10/2024] [Indexed: 01/30/2024]
Affiliation(s)
- Irmina Maria Michalek
- Polish National Cancer Registry, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Carmen Martos
- European Commission, Joint Research Centre, Ispra, Italy
| | | | | | | | - Luciana Neamtiu
- Cluj Cancer Registry, Institute of Oncology "Prof.dr. Ion Chiricuta", Cluj-Napoca, Romania; University Babes Bolyai, Cluj-Napoca, Romania
| | | | | | - Otto Visser
- Department of Registration, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, the Netherlands.
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Grassi J, Pessanha RM, Grippa WR, Dell’Antonio LS, Dell’Antonio CSDS, Faure L, Clavel J, Lopes-Júnior LC. Temporal Trends in the Completeness of Epidemiological Variables in a Hospital-Based Cancer Registry of a Pediatric Oncology Center in Brazil. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:200. [PMID: 38397690 PMCID: PMC10888061 DOI: 10.3390/ijerph21020200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/27/2024] [Accepted: 02/01/2024] [Indexed: 02/25/2024]
Abstract
This ecological time series study aimed to examine the temporal trends in the completeness of epidemiological variables from a hospital-based cancer registry (HbCR) of a reference center for pediatric oncology in Brazil from 2010 to 2016. Completeness categories were based on the percentage of missing data, with the categories excellent (<5%), good (5-10%), regular (11-20%), poor (21-50%), and very poor (>50%). Descriptive and bivariate analyses were performed using R.4.1.0; a Mann-Kendall trend test was performed to examine the temporal trends. Variables with the highest incompleteness included race/color (17.24% in 2016), level of education (51.40% in 2015), TNM (56.88% in 2012), disease status at the end of the first treatment (12.09% in 2013), cancer family history (79.12% in 2013), history of alcoholic consumption (39.25% in 2015), history of tobacco consumption (38.32% in 2015), and type of admission clinic (10.28% in 2015). Nevertheless, most variables achieved 100% completeness and were classified as excellent across the time series. A significant trend was observed for race/color, TNM, and history of tobacco consumption. While most variables maintained excellent completeness, the increasing incompleteness trend in race/color and decreasing trend in TNM underscore the importance of reliable and complete HbCRs for personalized cancer care, for planning public policies, and for conducting research on cancer control.
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Affiliation(s)
- Jonathan Grassi
- Graduate Program in Public Health, Universidade Federal do Espírito Santo (Ufes), Vitoria 29047-105, ES, Brazil; (J.G.); (R.M.P.); (W.R.G.)
| | - Raphael Manhães Pessanha
- Graduate Program in Public Health, Universidade Federal do Espírito Santo (Ufes), Vitoria 29047-105, ES, Brazil; (J.G.); (R.M.P.); (W.R.G.)
| | - Wesley Rocha Grippa
- Graduate Program in Public Health, Universidade Federal do Espírito Santo (Ufes), Vitoria 29047-105, ES, Brazil; (J.G.); (R.M.P.); (W.R.G.)
| | - Larissa Soares Dell’Antonio
- Espírito Santo State Health Department, Special Center for Epidemiological Surveillance, Vitoria 29047-105, ES, Brazil; (L.S.D.); (C.S.d.S.D.)
| | | | - Laure Faure
- Centre de Recherche en Epidémiologie et Statistiques (CRESS), Institut National de la Santé et de la Recherche Médicale—INSERM, Université Paris-Cité, 75013 Paris, France; (L.F.); (J.C.)
| | - Jacqueline Clavel
- Centre de Recherche en Epidémiologie et Statistiques (CRESS), Institut National de la Santé et de la Recherche Médicale—INSERM, Université Paris-Cité, 75013 Paris, France; (L.F.); (J.C.)
| | - Luís Carlos Lopes-Júnior
- Graduate Program in Public Health, Universidade Federal do Espírito Santo (Ufes), Vitoria 29047-105, ES, Brazil; (J.G.); (R.M.P.); (W.R.G.)
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7
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Lee S, Roh GH, Kim JY, Ho Lee Y, Woo H, Lee S. Effective data quality management for electronic medical record data using SMART DATA. Int J Med Inform 2023; 180:105262. [PMID: 37871445 DOI: 10.1016/j.ijmedinf.2023.105262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/03/2023] [Accepted: 10/11/2023] [Indexed: 10/25/2023]
Abstract
OBJECTIVES In the medical field, we face many challenges, including the high cost of data collection and processing, difficult standards issues, and complex preprocessing techniques. It is necessary to establish an objective and systematic data quality management system that ensures data reliability, mitigates risks caused by incorrect data, reduces data management costs, and increases data utilization. We introduce the concept of SMART data in a data quality management system and conducted a case study using real-world data on colorectal cancer. METHODS We defined the data quality management system from three aspects (Construction - Operation - Utilization) based on the life cycle of medical data. Based on this, we proposed the "SMART DATA" concept and tested it on colorectal cancer data, which is actual real-world data. RESULTS We define "SMART DATA" as systematized, high-quality data collected based on the life cycle of data construction, operation, and utilization through quality control activities for medical data. In this study, we selected a scenario using data on colorectal cancer patients from a single medical institution provided by the Clinical Oncology Network (CONNECT). As SMART DATA, we curated 1,724 learning data and 27 Clinically Critical Set (CCS) data for colorectal cancer prediction. These datasets contributed to the development and fine-tuning of the colorectal cancer prediction model, and it was determined that CCS cases had unique characteristics and patterns that warranted additional clinical review and consideration in the context of colorectal cancer prediction. CONCLUSIONS In this study, we conducted primary research to develop a medical data quality management system. This will standardize medical data extraction and quality control methods and increase the utilization of medical data. Ultimately, we aim to provide an opportunity to develop a medical data quality management methodology and contribute to the establishment of a medical data quality management system.
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Affiliation(s)
- Seunghee Lee
- Healthcare Data Science Center, Konyang University Hospital, Daejeon, 35365, Republic of Korea
| | - Gyun-Ho Roh
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jong-Yeup Kim
- Healthcare Data Science Center, Konyang University Hospital, Daejeon, 35365, Republic of Korea; Department of Biomedical Informatics, College of Medicine, Konyang University, Daejeon, 35365, Republic of Korea
| | - Young Ho Lee
- Department of Computer Engineering, Gachon University, Seongnam, Republic of Korea
| | - Hyekyung Woo
- Department of Health Administration, Kongju National University, Kongju, 32588, Republic of Korea.
| | - Suehyun Lee
- Department of Computer Engineering, Gachon University, Seongnam, Republic of Korea.
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Israels T, Arora RS, Sung L. The value of reporting on end-of-treatment outcome of patients in low-income settings. Pediatr Blood Cancer 2023; 70:e30686. [PMID: 37728943 DOI: 10.1002/pbc.30686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/30/2023] [Accepted: 09/10/2023] [Indexed: 09/22/2023]
Affiliation(s)
- Trijn Israels
- Collaborative African Network for Childhood Cancer Care and Research (CANCaRe Africa), Blantyre, Malawi
- Department of Paediatrics, Kamuzu University of Health Sciences, Blantyre, Malawi
| | | | - Lillian Sung
- Sick Children's Hospital, Toronto, Ontario, Canada
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Youlden DR, Baade PD, Frazier AL, Gupta S, Gottardo NG, Moore AS, Aitken JF. Temporal changes in childhood cancer incidence and survival by stage at diagnosis in Australia, 2000-2017. Acta Oncol 2023; 62:1256-1264. [PMID: 37647245 DOI: 10.1080/0284186x.2023.2251668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 08/20/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND The Toronto Paediatric Cancer Stage Guidelines are a compendium of staging systems developed to facilitate collection of consistent and comparable data on stage at diagnosis for childhood cancers by cancer registries. MATERIAL AND METHODS This retrospective, observational cohort study investigated changes in stage-specific incidence and survival for children diagnosed between 2000-2008 compared to 2009-2017 using the population-based Australian Childhood Cancer Registry. Information on mortality for each patient was available to 31st December 2020. Shifts in incidence by stage were evaluated using chi-square tests, and differences in stage-specific five-year observed survival for all causes of death over time were assessed using flexible parametric models. RESULTS Stage was assigned according to the Toronto Guidelines for 96% (n = 7944) of the total study cohort (n = 8292). Changes in the distribution of incidence by stage between the two diagnosis periods were observed for retinoblastoma, with stage 0 increasing from 26% to 37% of cases (p = 0.02), and hepatoblastoma, with metastatic disease increasing from 22% to 39% of cases (p = 0.04). There were large gains in stage-specific survival over time for stage IV rhabdomyosarcoma (five-year adjusted mortality hazard ratio for 2009-2017 compared to 2000-2008 of 0.38, 95% CI 0.19-0.77; p = 0.01), stage M3 for medulloblastoma (HR = 0.41, 95% CI 0.21-0.79; p = 0.01) and metastatic neuroblastoma excluding stage MS (HR = 0.61, 95% CI 0.44-0.84; p < 0.01). CONCLUSION These results indicate that improvements in childhood cancer survival in Australia are most likely due to refined management rather than changes in stage at diagnosis, particularly for metastatic solid tumours. Wide international uptake of the Toronto Guidelines will allow comprehensive evaluation of differences in survival between countries.
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Affiliation(s)
- Danny R Youlden
- Viertel Cancer Research Centre, Cancer Council Queensland, Brisbane, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Peter D Baade
- Viertel Cancer Research Centre, Cancer Council Queensland, Brisbane, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
- School of Mathematical Sciences, Queensland University of Technology, Brisbane, Australia
| | - A Lindsay Frazier
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, USA
| | - Sumit Gupta
- Division of Haematology/Oncology, Hospital for Sick Children, Toronto, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Nicolas G Gottardo
- Department of Paediatric and Adolescent Oncology/Haematology, Perth Children's Hospital, Perth, Australia
- Brain Tumour Research Program, Telethon Kids Cancer Centre, Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Andrew S Moore
- Oncology Service, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia
- Child Health Research Centre, The University of Queensland, Brisbane, Australia
| | - Joanne F Aitken
- Viertel Cancer Research Centre, Cancer Council Queensland, Brisbane, Australia
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
- School of Public Health, The University of Queensland, Brisbane, Australia
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10
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Lopez-Cortes A, Didonè F, Botta L, Hjalgrim LL, Jakab Z, Cañete Nieto A, Stiller C, Zeller B, Gatta G, Pritchard-Jones K. Cancer data quality and harmonization in Europe: the experience of the BENCHISTA Project - international benchmarking of childhood cancer survival by stage. Front Oncol 2023; 13:1232451. [PMID: 37675230 PMCID: PMC10477775 DOI: 10.3389/fonc.2023.1232451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 07/24/2023] [Indexed: 09/08/2023] Open
Abstract
Introduction Variation in stage at diagnosis of childhood cancers (CC) may explain differences in survival rates observed across geographical regions. The BENCHISTA project aims to understand these differences and to encourage the application of the Toronto Staging Guidelines (TG) by Population-Based Cancer Registries (PBCRs) to the most common solid paediatric cancers. Methods PBCRs within and outside Europe were invited to participate and identify all cases of Neuroblastoma, Wilms Tumour, Medulloblastoma, Ewing Sarcoma, Rhabdomyosarcoma and Osteosarcoma diagnosed in a consecutive three-year period (2014-2017) and apply TG at diagnosis. Other non-stage prognostic factors, treatment, progression/recurrence, and cause of death information were collected as optional variables. A minimum of three-year follow-up was required. To standardise TG application by PBCRs, on-line workshops led by six tumour-specific clinical experts were held. To understand the role of data availability and quality, a survey focused on data collection/sharing processes and a quality assurance exercise were generated. To support data harmonization and query resolution a dedicated email and a question-and-answers bank were created. Results 67 PBCRs from 28 countries participated and provided a maximally de-personalized, patient-level dataset. For 26 PBCRs, data format and ethical approval obtained by the two sponsoring institutions (UCL and INT) was sufficient for data sharing. 41 participating PBCRs required a Data Transfer Agreement (DTA) to comply with data protection regulations. Due to heterogeneity found in legal aspects, 18 months were spent on finalizing the DTA. The data collection survey was answered by 68 respondents from 63 PBCRs; 44% of them confirmed the ability to re-consult a clinician in cases where stage ascertainment was difficult/uncertain. Of the total participating PBCRs, 75% completed the staging quality assurance exercise, with a median correct answer proportion of 92% [range: 70% (rhabdomyosarcoma) to 100% (Wilms tumour)]. Conclusion Differences in interpretation and processes required to harmonize general data protection regulations across countries were encountered causing delays in data transfer. Despite challenges, the BENCHISTA Project has established a large collaboration between PBCRs and clinicians to collect detailed and standardised TG at a population-level enhancing the understanding of the reasons for variation in overall survival rates for CC, stimulate research and improve national/regional child health plans.
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Affiliation(s)
- Angela Lopez-Cortes
- University College London (UCL) Great Ormond Street Institute of Child Health, Developmental Biology & Cancer Research Department, London, United Kingdom
| | - Fabio Didonè
- Fondazione IRCCS “Istituto Nazionale dei Tumori di Milano” (INT), Department of Evaluative Epidemiology, Milan, Italy
| | - Laura Botta
- Fondazione IRCCS “Istituto Nazionale dei Tumori di Milano” (INT), Department of Evaluative Epidemiology, Milan, Italy
| | | | | | | | | | | | - Gemma Gatta
- Fondazione IRCCS “Istituto Nazionale dei Tumori di Milano” (INT), Department of Evaluative Epidemiology, Milan, Italy
| | - Kathy Pritchard-Jones
- University College London (UCL) Great Ormond Street Institute of Child Health, Developmental Biology & Cancer Research Department, London, United Kingdom
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11
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Zheng H, Wang F, Li Y, Li Z, Zhang X, Yin X. Promoting the application of pediatric radiomics via an integrated medical engineering approach. CANCER INNOVATION 2023; 2:302-311. [DOI: 10.1002/cai2.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 11/27/2022] [Indexed: 11/15/2023]
Abstract
AbstractRadiomics is widely used in adult tumors but has been rarely applied to the field of pediatrics. Promoting the application of radiomics in pediatric diseases, especially in the early diagnosis and stratified treatment of tumors, is of great value to the realization of the WHO 2030 “Global Initiative for Childhood Cancer.” This paper discusses the general characteristics of radiomics, the particularity of its application to pediatric diseases, and the current status and prospects of pediatric radiomics. Radiomics is a data‐driven science, and the combination of medicine and engineering plays a decisive role in improving data quality, data diversity, and sample size. Compared with adult radiomics, pediatric radiomics is significantly different in data type, disease spectrum, disease staging, and progression. Some progress has been made in the identification, classification, stratification, survival prediction, and prognosis of tumor diseases. In the future, big data applications from multiple centers and cross‐talent training should be strengthened to improve the benefits for clinical workers and children.
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Affiliation(s)
- Haige Zheng
- Department of Radiology, Guangzhou Women and Children's Medical Center Guangdong Provincial Clinical Research Center for Child Health Guangzhou China
| | - Fang Wang
- Lianying Intelligent Medical Technology (Chengdu) Co., Ltd. Chengdu China
| | - Yang Li
- Lianying Intelligent Medical Technology (Chengdu) Co., Ltd. Chengdu China
| | - Zhicheng Li
- Institute of Biomedical and Health Engineering, Shenzhen Institute of Advanced Technology Chinese Academy of Sciences Shenzhen China
| | - Xiaochun Zhang
- Department of Radiology, Guangzhou Women and Children's Medical Center Guangdong Provincial Clinical Research Center for Child Health Guangzhou China
| | - Xuntao Yin
- Department of Radiology, Guangzhou Women and Children's Medical Center Guangdong Provincial Clinical Research Center for Child Health Guangzhou China
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12
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Rashidi A, Baratto L, Theruvath AJ, Greene EB, Jayapal P, Hawk KE, Lu R, Seekins J, Spunt SL, Pribnow A, Daldrup-Link HE. Improved Detection of Bone Metastases in Children and Young Adults with Ferumoxytol-enhanced MRI. Radiol Imaging Cancer 2023; 5:e220080. [PMID: 36999999 PMCID: PMC10077085 DOI: 10.1148/rycan.220080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 01/25/2023] [Accepted: 02/10/2023] [Indexed: 04/12/2023]
Abstract
Purpose To evaluate if ferumoxytol can improve the detection of bone marrow metastases at diffusion-weighted (DW) MRI in pediatric and young adult patients with cancer. Materials and Methods In this secondary analysis of a prospective institutional review board-approved study (ClinicalTrials.gov identifier NCT01542879), 26 children and young adults (age range: 2-25 years; 18 males) underwent unenhanced or ferumoxytol-enhanced whole-body DW MRI between 2015 and 2020. Two reviewers determined the presence of bone marrow metastases using a Likert scale. One additional reviewer measured signal-to-noise ratios (SNRs) and tumor-to-bone marrow contrast. Fluorine 18 (18F) fluorodeoxyglucose (FDG) PET and follow-up chest CT, abdominal and pelvic CT, and standard (non-ferumoxytol enhanced) MRI served as the reference standard. Results of different experimental groups were compared using generalized estimation equations, Wilcoxon rank sum test, and Wilcoxon signed rank test. Results The SNR of normal bone marrow was significantly lower at ferumoxytol-enhanced MRI compared with unenhanced MRI at baseline (21.380 ± 19.878 vs 102.621 ± 94.346, respectively; P = .03) and after chemotherapy (20.026 ± 7.664 vs 54.110 ± 48.022, respectively; P = .006). This led to an increased tumor-to-marrow contrast on ferumoxytol-enhanced MRI scans compared with unenhanced MRI scans at baseline (1397.474 ± 938.576 vs 665.364 ± 440.576, respectively; P = .07) and after chemotherapy (1099.205 ± 864.604 vs 500.758 ± 439.975, respectively; P = .007). Accordingly, the sensitivity and diagnostic accuracy for detecting bone marrow metastases were 96% (94 of 98) and 99% (293 of 297), respectively, with the use of ferumoxytol-enhanced MRI compared with 83% (106 of 127) and 95% (369 of 390) with the use of unenhanced MRI. Conclusion Use of ferumoxytol helped improve the detection of bone marrow metastases in children and young adults with cancer. Keywords: Pediatrics, Molecular Imaging-Cancer, Molecular Imaging-Nanoparticles, MR-Diffusion Weighted Imaging, MR Imaging, Skeletal-Appendicular, Skeletal-Axial, Bone Marrow, Comparative Studies, Cancer Imaging, Ferumoxytol, USPIO © RSNA, 2023 ClinicalTrials.gov registration no. NCT01542879 See also the commentary by Holter-Chakrabarty and Glover in this issue.
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Affiliation(s)
- Ali Rashidi
- From the Department of Radiology, Molecular Imaging Program at
Stanford (A.R., L.B., A.J.T., K.E.H., J.S., H.E.D.L.), and Department of
Radiology, Division of Pediatric Radiology (E.B.G., P.J.), Lucile Packard
Children’s Hospital, Stanford University School of Medicine, 725 Welch
Rd, Stanford, CA 94305-5654; and Quantitative Sciences Unit (R.L.) and
Department of Pediatrics, Division of Hematology/Oncology (S.L.S., A.P.,
H.E.D.L.), Stanford University School of Medicine, Stanford, Calif
| | - Lucia Baratto
- From the Department of Radiology, Molecular Imaging Program at
Stanford (A.R., L.B., A.J.T., K.E.H., J.S., H.E.D.L.), and Department of
Radiology, Division of Pediatric Radiology (E.B.G., P.J.), Lucile Packard
Children’s Hospital, Stanford University School of Medicine, 725 Welch
Rd, Stanford, CA 94305-5654; and Quantitative Sciences Unit (R.L.) and
Department of Pediatrics, Division of Hematology/Oncology (S.L.S., A.P.,
H.E.D.L.), Stanford University School of Medicine, Stanford, Calif
| | - Ashok Joseph Theruvath
- From the Department of Radiology, Molecular Imaging Program at
Stanford (A.R., L.B., A.J.T., K.E.H., J.S., H.E.D.L.), and Department of
Radiology, Division of Pediatric Radiology (E.B.G., P.J.), Lucile Packard
Children’s Hospital, Stanford University School of Medicine, 725 Welch
Rd, Stanford, CA 94305-5654; and Quantitative Sciences Unit (R.L.) and
Department of Pediatrics, Division of Hematology/Oncology (S.L.S., A.P.,
H.E.D.L.), Stanford University School of Medicine, Stanford, Calif
| | - Elton Benjamin Greene
- From the Department of Radiology, Molecular Imaging Program at
Stanford (A.R., L.B., A.J.T., K.E.H., J.S., H.E.D.L.), and Department of
Radiology, Division of Pediatric Radiology (E.B.G., P.J.), Lucile Packard
Children’s Hospital, Stanford University School of Medicine, 725 Welch
Rd, Stanford, CA 94305-5654; and Quantitative Sciences Unit (R.L.) and
Department of Pediatrics, Division of Hematology/Oncology (S.L.S., A.P.,
H.E.D.L.), Stanford University School of Medicine, Stanford, Calif
| | - Praveen Jayapal
- From the Department of Radiology, Molecular Imaging Program at
Stanford (A.R., L.B., A.J.T., K.E.H., J.S., H.E.D.L.), and Department of
Radiology, Division of Pediatric Radiology (E.B.G., P.J.), Lucile Packard
Children’s Hospital, Stanford University School of Medicine, 725 Welch
Rd, Stanford, CA 94305-5654; and Quantitative Sciences Unit (R.L.) and
Department of Pediatrics, Division of Hematology/Oncology (S.L.S., A.P.,
H.E.D.L.), Stanford University School of Medicine, Stanford, Calif
| | - K. Elizabeth Hawk
- From the Department of Radiology, Molecular Imaging Program at
Stanford (A.R., L.B., A.J.T., K.E.H., J.S., H.E.D.L.), and Department of
Radiology, Division of Pediatric Radiology (E.B.G., P.J.), Lucile Packard
Children’s Hospital, Stanford University School of Medicine, 725 Welch
Rd, Stanford, CA 94305-5654; and Quantitative Sciences Unit (R.L.) and
Department of Pediatrics, Division of Hematology/Oncology (S.L.S., A.P.,
H.E.D.L.), Stanford University School of Medicine, Stanford, Calif
| | - Rong Lu
- From the Department of Radiology, Molecular Imaging Program at
Stanford (A.R., L.B., A.J.T., K.E.H., J.S., H.E.D.L.), and Department of
Radiology, Division of Pediatric Radiology (E.B.G., P.J.), Lucile Packard
Children’s Hospital, Stanford University School of Medicine, 725 Welch
Rd, Stanford, CA 94305-5654; and Quantitative Sciences Unit (R.L.) and
Department of Pediatrics, Division of Hematology/Oncology (S.L.S., A.P.,
H.E.D.L.), Stanford University School of Medicine, Stanford, Calif
| | - Jayne Seekins
- From the Department of Radiology, Molecular Imaging Program at
Stanford (A.R., L.B., A.J.T., K.E.H., J.S., H.E.D.L.), and Department of
Radiology, Division of Pediatric Radiology (E.B.G., P.J.), Lucile Packard
Children’s Hospital, Stanford University School of Medicine, 725 Welch
Rd, Stanford, CA 94305-5654; and Quantitative Sciences Unit (R.L.) and
Department of Pediatrics, Division of Hematology/Oncology (S.L.S., A.P.,
H.E.D.L.), Stanford University School of Medicine, Stanford, Calif
| | - Sheri L. Spunt
- From the Department of Radiology, Molecular Imaging Program at
Stanford (A.R., L.B., A.J.T., K.E.H., J.S., H.E.D.L.), and Department of
Radiology, Division of Pediatric Radiology (E.B.G., P.J.), Lucile Packard
Children’s Hospital, Stanford University School of Medicine, 725 Welch
Rd, Stanford, CA 94305-5654; and Quantitative Sciences Unit (R.L.) and
Department of Pediatrics, Division of Hematology/Oncology (S.L.S., A.P.,
H.E.D.L.), Stanford University School of Medicine, Stanford, Calif
| | - Allison Pribnow
- From the Department of Radiology, Molecular Imaging Program at
Stanford (A.R., L.B., A.J.T., K.E.H., J.S., H.E.D.L.), and Department of
Radiology, Division of Pediatric Radiology (E.B.G., P.J.), Lucile Packard
Children’s Hospital, Stanford University School of Medicine, 725 Welch
Rd, Stanford, CA 94305-5654; and Quantitative Sciences Unit (R.L.) and
Department of Pediatrics, Division of Hematology/Oncology (S.L.S., A.P.,
H.E.D.L.), Stanford University School of Medicine, Stanford, Calif
| | - Heike E. Daldrup-Link
- From the Department of Radiology, Molecular Imaging Program at
Stanford (A.R., L.B., A.J.T., K.E.H., J.S., H.E.D.L.), and Department of
Radiology, Division of Pediatric Radiology (E.B.G., P.J.), Lucile Packard
Children’s Hospital, Stanford University School of Medicine, 725 Welch
Rd, Stanford, CA 94305-5654; and Quantitative Sciences Unit (R.L.) and
Department of Pediatrics, Division of Hematology/Oncology (S.L.S., A.P.,
H.E.D.L.), Stanford University School of Medicine, Stanford, Calif
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13
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Giusti F, Martos C, Trama A, Bettio M, Sanvisens A, Audisio R, Arndt V, Francisci S, Dochez C, Ribes J, Fernández LP, Gavin A, Gatta G, Marcos-Gragera R, Lievens Y, Allemani C, De Angelis R, Visser O, Van Eycken L. Cancer treatment data available in European cancer registries: Where are we and where are we going? Front Oncol 2023; 13:1109978. [PMID: 36845700 PMCID: PMC9944949 DOI: 10.3389/fonc.2023.1109978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 01/20/2023] [Indexed: 02/10/2023] Open
Abstract
Population-based cancer registries are responsible for collecting incidence and survival data on all reportable neoplasms within a defined geographical area. During the last decades, the role of cancer registries has evolved beyond monitoring epidemiological indicators, as they are expanding their activities to studies on cancer aetiology, prevention, and quality of care. This expansion relies also on the collection of additional clinical data, such as stage at diagnosis and cancer treatment. While the collection of data on stage, according to international reference classification, is consolidated almost everywhere, data collection on treatment is still very heterogeneous in Europe. This article combines data from a literature review and conference proceedings together with data from 125 European cancer registries contributing to the 2015 ENCR-JRC data call to provide an overview of the status of using and reporting treatment data in population-based cancer registries. The literature review shows that there is an increase in published data on cancer treatment by population-based cancer registries over the years. In addition, the review indicates that treatment data are most often collected for breast cancer, the most frequent cancer in women in Europe, followed by colorectal, prostate and lung cancers, which are also more common. Treatment data are increasingly being reported by cancer registries, though further improvements are required to ensure their complete and harmonised collection. Sufficient financial and human resources are needed to collect and analyse treatment data. Clear registration guidelines are to be made available to increase the availability of real-world treatment data in a harmonised way across Europe.
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Affiliation(s)
- Francesco Giusti
- European Commission, Joint Research Centre (JRC), Ispra, Italy,Belgian Cancer Registry, Brussels, Belgium,*Correspondence: Francesco Giusti, ;
| | - Carmen Martos
- European Commission, Joint Research Centre (JRC), Ispra, Italy,Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
| | - Annalisa Trama
- Evaluative Epidemiology Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Manola Bettio
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Arantza Sanvisens
- Epidemiology Unit and Girona Cancer Registry, Catalan Institute of Oncology, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia; Girona Biomedical Research Institute (IDIBGI), Girona, Spain
| | - Riccardo Audisio
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Volker Arndt
- Epidemiological Cancer Registry Baden-Württemberg (M110) & Unit of Cancer Survivorship (C071), Division of Clinical Epidemiology and Aging Research (C070), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Silvia Francisci
- National Centre for Disease Prevention and Health Promotion, Istituto Superiore di Sanità, Rome, Italy
| | | | - Josepa Ribes
- Catalan Cancer Plan, Department of Health of Catalonia, Hospitalet del Llobregat, Barcelona, Spain
| | - Laura Pareja Fernández
- Catalan Cancer Plan, Department of Health of Catalonia, Hospitalet del Llobregat, Barcelona, Spain
| | - Anna Gavin
- Northern Ireland Cancer Registry, Centre for Public Health, Queen’s University Belfast, Belfast, Ireland
| | - Gemma Gatta
- Evaluative Epidemiology Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Rafael Marcos-Gragera
- Epidemiology Unit and Girona Cancer Registry, Catalan Institute of Oncology, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia; Girona Biomedical Research Institute (IDIBGI), Girona, Spain
| | - Yolande Lievens
- Department of Radiation Oncology, Ghent University Hospital and Ghent University, Ghent, Belgium
| | - Claudia Allemani
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Roberta De Angelis
- Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - Otto Visser
- Department of Registration, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands
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14
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Pung L, Moorin R, Trevithick R, Taylor K, Chai K, Garcia Gewerc C, Ha N, Smith S. Determining cancer stage at diagnosis in population-based cancer registries: A rapid scoping review. FRONTIERS IN HEALTH SERVICES 2023; 3:1039266. [PMID: 36926511 PMCID: PMC10012750 DOI: 10.3389/frhs.2023.1039266] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 02/03/2023] [Indexed: 03/18/2023]
Abstract
Introduction Population-based cancer registries are the main source of data for population-level analysis of cancer stage at diagnosis. This data enables analysis of cancer burden by stage, evaluation of screening programs and provides insight into differences in cancer outcomes. The lack of standardised collection of cancer staging in Australia is well recognised and is not routinely collected within the Western Australia Cancer Registry. This review aimed to explore how cancer stage at diagnosis is determined in population-based cancer registries. Methods This review was guided by the Joanna-Briggs Institute methodology. A systematic search of peer-reviewed research studies and grey literature from 2000 to 2021 was conducted in December 2021. Literature was included if peer-reviewed articles or grey literature sources used population-based cancer stage at diagnosis, and were published in English between 2000 and 2021. Literature was excluded if they were reviews or only the abstract was available. Database results were screened by title and abstract using Research Screener. Full-texts were screened using Rayyan. Included literature were analysed using thematic analysis and managed through NVivo. Results The findings of the 23 included articles published between 2002 and 2021 consisted of two themes. (1) "Data sources and collection processes" outlines the data sources used, as well as the processes and timing of data collection utilised by population-based cancer registries. (2) "Staging classification systems" reveals the staging classification systems employed or developed for population-based cancer staging, including the American Joint Committee on Cancer's Tumour Node Metastasis and related systems; simplified systems classified into localised, regional, and distant categories; and miscellaneous systems. Conclusions Differences in approaches used to determine population-based cancer stage at diagnosis challenge attempts to make interjurisdictional and international comparisons. Barriers to collecting population-based stage at diagnosis include resource availability, infrastructure differences, methodological complexity, interest variations, and differences in population-based roles and emphases. Even within countries, disparate funding sources and funder interests can challenge the uniformity of population-based cancer registry staging practices. International guidelines to guide cancer registries in collecting population-based cancer stage is needed. A tiered framework of standardising collection is recommended. The results will inform integrating population-based cancer staging into the Western Australian Cancer Registry.
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Affiliation(s)
- Li Pung
- School of Population Health, Curtin University, Perth, WA, Australia.,Public Health, North Metropolitan Health Service, Perth, WA, Australia
| | - Rachael Moorin
- School of Population Health, Curtin University, Perth, WA, Australia.,School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | - Richard Trevithick
- Department of Health, Western Australia Cancer Registry, Clinical Excellence Division, Perth, WA, Australia
| | - Karen Taylor
- Cancer Network WA, North Metropolitan Health Service, Perth, WA, Australia
| | - Kevin Chai
- School of Population Health, Curtin University, Perth, WA, Australia
| | | | - Ninh Ha
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Stephanie Smith
- School of Population Health, Curtin University, Perth, WA, Australia
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15
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Youlden DR, Baade PD, Moore AS, Pole JD, Valery PC, Aitken JF. Childhood cancer survival and avoided deaths in Australia, 1983-2016. Paediatr Perinat Epidemiol 2023; 37:81-91. [PMID: 35672573 PMCID: PMC10084119 DOI: 10.1111/ppe.12895] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/22/2022] [Accepted: 04/05/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Large improvements in childhood cancer survival have been reported over recent decades. Data from cancer registries have the advantage of providing a 'whole of population' approach to gauge the success of cancer control efforts. OBJECTIVES The aim of this study was to investigate recent survival estimates for children diagnosed with cancer Australia and to examine the extent of changes in survival over the last 35 years. For the first time, we also estimated the number of deaths among Australian children that were potentially avoided due to improvements in survival. METHODS A retrospective, population-based cohort study design was used. Case information was extracted from the Australian Childhood Cancer Registry for 1983-2016, with follow-up to 31 December 2017. Eligible children were aged 0-14 with a basis of diagnosis other than autopsy or death certificate only. Five-year relative survival was calculated using the semi-complete cohort method for three diagnosis periods (1983-1994, 1995-2006 and 2007-2016), and changes in survival over time were assessed via flexible parametric models. Avoided deaths within 5 years for those diagnosed between 1995 and 2016 were estimated under the assumption that survival rates remained the same as for 1983-1994. RESULTS Overall 5-year survival within the study cohort (n = 20,871) increased from 72.8% between 1983 and1994 to 86.1% between 2007 and 2016, equating to an adjusted excess mortality hazard ratio of 1.82 (95% confidence interval 1.67, 1.97). Most cancers showed improvements in survival; other gliomas, hepatoblastoma and osteosarcoma were exceptions. Among children diagnosed between 1995 and 2016, 38.7% of expected deaths within 5 years of diagnosis (n = 1537 of 3970) were avoided due to temporal improvements in survival. CONCLUSIONS Survival for childhood cancer has continued to improve over recent years, thanks mainly to ongoing progress in treatment development combined with improved supportive care. Providing innovative measures of survival, such as avoided deaths, may assist with understanding outcome data produced by cancer registries.
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Affiliation(s)
- Danny R Youlden
- Cancer Council Queensland, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Peter D Baade
- Cancer Council Queensland, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.,School of Mathematical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Andrew S Moore
- Oncology Service, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia.,Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Jason D Pole
- Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Patricia C Valery
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Joanne F Aitken
- Cancer Council Queensland, Brisbane, Queensland, Australia.,Institute for Resilient Regions, University of Southern Queensland, Brisbane, Queensland, Australia.,School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
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16
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Delavar A, Wali AR, Santiago-Dieppa DR, Al Jammal OM, Kidwell RL, Khalessi AA. Racial and ethnic disparities in brain tumour survival by age group and tumour type. Br J Neurosurg 2022; 36:705-711. [PMID: 35762526 DOI: 10.1080/02688697.2022.2090507] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
PURPOSE The extent to which racial/ethnic brain tumour survival disparities vary by age is not very clear. In this study, we assess racial/ethnic brain tumour survival disparities overall by age group and type. METHODS Data were obtained from the Surveillance, Epidemiology, and End Results (SEER) 18 registries for US-based individuals diagnosed with a first primary malignant tumour from 2007 through 2016. Cox proportional hazards regression was used to compute adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the association between race/ethnicity and brain tumour survival, stratified by age group and tumour type. RESULTS After adjusting for sex, socioeconomic status, insurance status, and tumour type, non-Hispanic (NH) Blacks (HR: 1.26; 95% CI: 1.02-1.55), NH Asian or Pacific Islanders (HR: 1.29; 95% CI: 1.01-1.66), and Hispanics (any race) (HR: 1.28; 95% CI: 1.09-1.51) all showed a survival disadvantage compared with NH Whites for the youngest age group studied (0-9 years). Furthermore, NH Blacks (HR: 0.88; 95% CI: 0.91-0.97), NH Asian or Pacific Islanders (HR: 0.84; 95% CI: 0.77-0.92), and Hispanics (any race) (HR: 0.91; 95% CI: 0.85-0.97) all showed a survival advantage compared with NH Whites for the 60-79 age group. Tests for interactions showed significant trends, indicating that racial/ethnic survival disparities disappear and even reverse for older age groups (P < 0.001). This reversal appears to be driven by poor glioblastoma survival among NH Whites (P < 0.001). CONCLUSION Disparities in brain tumour survival among minorities exist primarily among children and adolescents. NH White adults show worse survival than their minority counterparts, which is possibly driven by poor glioblastoma biology.
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Affiliation(s)
- Arash Delavar
- Department of Neurological Surgery, University of California, San Diego La Jolla, CA, USA
| | - Arvin R Wali
- Department of Neurological Surgery, University of California, San Diego La Jolla, CA, USA
| | | | - Omar M Al Jammal
- Department of Neurological Surgery, University of California, San Diego La Jolla, CA, USA
| | - Reilly L Kidwell
- Department of Neurological Surgery, University of California, San Diego La Jolla, CA, USA
| | - Alexander A Khalessi
- Department of Neurological Surgery, University of California, San Diego La Jolla, CA, USA
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17
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Botta L, Gatta G, Didonè F, Lopez Cortes A, Pritchard-Jones K. International benchmarking of childhood cancer survival by stage at diagnosis: The BENCHISTA project protocol. PLoS One 2022; 17:e0276997. [PMID: 36327231 PMCID: PMC9632762 DOI: 10.1371/journal.pone.0276997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022] Open
Abstract
Background Several studies have shown significant variation in overall survival rates from childhood cancer between countries, using population-based cancer registry (PBCR) data for all cancers combined and for many individual tumour types among children. Without accurate and comparable data on Tumour stage at diagnosis, it is difficult to define the reasons for these survival differences. This is because measurement systems designed for adult cancers do not apply to children’s cancers and cancer registries often hold limited information on paediatric tumour stage and the data sources used to define it. Aims The BENCHISTA project aims to test the application of the international consensus “Toronto Staging Guidelines” (TG) for paediatric tumours by European and non-European PBCRs for six common paediatric solid tumours so that reliable comparisons of stage at diagnosis and survival rates by stage can be made to understand any differences. A secondary aim is to test the data availability and completeness of collection of several ‘Toronto’ consensus non-stage prognostic factors, treatment types given, occurrence of relapse/progression and cause of death as a descriptive feasibility study. Methods PBCRs will use their permitted data access channels to apply the Toronto staging guidelines to all incident cases of six solid childhood cancers (medulloblastoma, osteosarcoma, Ewings sarcoma, rhabdomyosarcoma, neuroblastoma and Wilms tumour) diagnosed in a consecutive three-year period within 2014–2017 in their population. Each registry will provide a de-identified patient-level dataset including tumour stage at diagnosis, with only the contributing registry holding the information that would be needed to re-identify the patients. Where available to the registry, patient-level data on ‘Toronto’ non-stage prognostic factors, treatments given and clinical outcomes (relapse/progression/cause of death) will be included. More than 60 PBCRs have been involved in defining the patient-level dataset items and intend to participate by contributing their population-level data. Tumour-specific on-line training workshops with clinical experts are available to cancer registry staff to assist them in applying the Toronto staging guidelines in a consistent manner. There is also a project-specific help desk for discussion of difficult cases and promotion of the CanStaging online tools, developed through the International Association of Cancer Registries, to further ensure standardisation of data collection. Country-specific stage distribution and observed survival by stage at diagnosis will be calculated for each tumour type to compare survival between countries or large geographical regions. Discussion This study will be promote and enhance the collection of standardized staging data for childhood cancer by European and non-European population-based cancer registries. Therefore, this project can be seen as a feasibility project of widespread use of Toronto Staging at a population-level by cancer registries, specifying the data sources used and testing how well standardized the processes can be. Variation in tumour stage distribution could be due to real differences, to different diagnostic practices between countries and/or to variability in how cancer registries assign Toronto stage. This work also aims to strengthen working relationships between cancer registries, clinical services and cancer-specific clinical study groups, which is important for improving patient outcomes and stimulating research.
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Affiliation(s)
- Laura Botta
- Fondazione IRCCS “Istituto Nazionale dei Tumori di Milano”, INT, Milan, Italy
| | - Gemma Gatta
- Fondazione IRCCS “Istituto Nazionale dei Tumori di Milano”, INT, Milan, Italy
| | - Fabio Didonè
- Fondazione IRCCS “Istituto Nazionale dei Tumori di Milano”, INT, Milan, Italy
- * E-mail:
| | - Angela Lopez Cortes
- UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Kathy Pritchard-Jones
- UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
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18
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Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic. BMJ Glob Health 2022; 7:e008797. [PMID: 36261229 PMCID: PMC9581782 DOI: 10.1136/bmjgh-2022-008797] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 04/13/2022] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality. METHODS Prospective cohort study in 109 institutions in 41 countries. INCLUSION CRITERIA children <18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months. RESULTS All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3-11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p<0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p<0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p<0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality. CONCLUSIONS Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer.
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19
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Luo Y, Zhou C, He F, Fan J, Wen X, Ding Y, Han Y, Ding J, Jin M, Liu Z, Wang S, Han M, Yuan H, Sun H, Xiao Y, Wu L, Wang J, Li Y, Yang H, Yu J, Gong J, Xu Y, Wen Y, Gao Z, Mei L, Ye J, Liu H, Chen Z, Xue S, Liu R, Chen H, Lu W, Liao H, Guo Q, Cui J, Zhu D, Lu F, Tang S, Wu Y, Yangkyi T, Guanghong Z, Wubuli M, Huiyu G, Wang X, He Y, Sheng X, Wang Q, Tan J, Liang J, Sun X, Zhang J, Ji X, Jin L, Zhao J, Yang X, Jia R, Fan X. Contemporary Update of Retinoblastoma in China: Three-Decade Changes in Epidemiology, Clinical Features, Treatments, and Outcomes. Am J Ophthalmol 2022; 236:193-203. [PMID: 34626572 DOI: 10.1016/j.ajo.2021.09.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 05/30/2021] [Accepted: 09/22/2021] [Indexed: 02/05/2023]
Abstract
PURPOSE To report three-decade changes of clinical characteristics, progress of treatments, and risk factors associated with mortality and enucleation in patients with retinoblastoma in China. DESIGN Retrospective cohort study. METHODS This multicenter study included 2552 patients diagnosed with retinoblastoma in 38 medical centers in 31 provinces in China from 1989 to 2017, with follow-up data. Kendall's tau-b value was used to describe correlation coefficients between the three eras (between 1989 and 2008, between 2009 and 2013, and between 2014 and 2017) and clinical or demographic features. Hazard ratios and odds ratios were applied to measure risk factors. RESULTS A total of 324 (13%) patients died and 1414 (42%) eyes were removed. The 1-year, 3-year, and 5-year overall survival rates were 95%, 86%, and 83%, respectively. Patients were diagnosed at a better stage by International Classification for Retinoblastoma over time (Kendall's tau-b value = -0.084, P < .001). Pathological risk factors were also observed less in recent eras. New conservative therapies were adopted and used in more patients. The eye removal rate gradually decreased (Kendall's tau-b value = -0.167, P < .001). The overall survival rates were 81%, 83%, and 91% in the three eras. By multivariate Cox regression, bilateral tumors and extraocular extension were identified as risk factors for death. Among intraocular disease, Group E indicated higher risk of mortality. By multivariate logistics regression, unilateral tumors, earlier era of diagnosis, and extraocular extension were risk factors for eye salvage failure. Among intraocular retinoblastoma, Groups D and E had higher risk of eye salvage failure. CONCLUSIONS Patients were diagnosed at an earlier stage in recent eras. Conservative therapies, including intra-arterial chemotherapy, were increasingly being used. The above changes may contribute to the decreasing enucleation rate. Although no significant impact was identified on the mortality by the three eras, a decreasing trend was shown.
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Affiliation(s)
- Yingxiu Luo
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, M.H, R.J, X.F); Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, R.J, X.F)
| | - Chuandi Zhou
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, M.H, R.J, X.F); Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, R.J, X.F)
| | - Fanglin He
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, M.H, R.J, X.F); Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, R.J, X.F)
| | - Jiayan Fan
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, M.H, R.J, X.F); Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, R.J, X.F)
| | - Xuyang Wen
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, M.H, R.J, X.F); Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, R.J, X.F)
| | - Yi Ding
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, M.H, R.J, X.F); Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, R.J, X.F)
| | - Yanping Han
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, M.H, R.J, X.F); Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, R.J, X.F)
| | - Jingwen Ding
- Department of Ophthalmology, Beijing Tongren Hospital (J.D)
| | - Mei Jin
- Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University (M.J, J.Z)
| | - Zhenyin Liu
- Department of Ophthalmology, Guangzhou Women and Children's Medical Center (Z.L, J.Z)
| | - Sha Wang
- Department of Ophthalmology, Central South University Xiangya School of Medicine (S.W, J.T)
| | - Minglei Han
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, M.H, R.J, X.F); Department of Ophthalmology, Qilu Children's Hospital of Shandong University (M.H)
| | - Hongfeng Yuan
- Department of Ophthalmology, the First hospital Affiliated with AMU (H.Y)
| | - Hong Sun
- Department of Ophthalmology, Shandong Provincial Hospital (H.S)
| | - Yishuang Xiao
- Department of Ophthalmology, Kunming Children's Hospital (Y.X)
| | - Li Wu
- Department of Ophthalmology, Wuhan University Renmin Hospital (L.W)
| | - Jiancang Wang
- Department of Ophthalmology, Hebei Children's Hospital (J.W)
| | - Yangjun Li
- Department of Ophthalmology, Xi'an Tangdu Hospital of No.4 Military Medical University (Y.L)
| | - Huasheng Yang
- Zhongshan Ophthalmic Center, Sun Yat-sen University (H.Y)
| | - Jiawei Yu
- Department of Ophthalmology, Harbin Children's Hospital (J.Y)
| | - Jianyang Gong
- Ophthalmology of the First Affiliated Hospital Anhui Medical University (J.G)
| | - Yuxin Xu
- Department of Ophthalmology, the Second affiliated Hospital of Anhui Medical University (Y.X)
| | - Yuechun Wen
- Department of Ophthalmology, the Provincial Hospital Affiliated to Anhui Medical University (Y.W)
| | - Ziqing Gao
- Department of Ophthalmology, the First Affiliated Hospital of Bengbu Medical College (Z.G)
| | - Lixin Mei
- Department of Ophthalmogy, Yijishan Hospital, Wannan Medical College (L.M)
| | - Juan Ye
- Department of Ophthalmology, the Second Affiliated Hospital Zhejiang University School of Medicine (J.Y)
| | - Hu Liu
- Jiangsu Province Hospital (H.L)
| | - Zhijun Chen
- Children's Hospital of Nanjing Medical University (Z.C)
| | - Shangcai Xue
- Second Provincial People's Hospital of Gansu (S.X)
| | - Rong Liu
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (R.L)
| | - Hong Chen
- Department of Ophthalmology, Union Hospital Affiliated with Tongji Medical College, Huazhong University of Science and Technology, Wuhan (H.C)
| | - Wei Lu
- Department of Ophthalmology, the Second Hospital of Dalian Medical University (W.L)
| | - Hongfei Liao
- Department of Ocular Trauma and Orbital Diseases, Affiliated Eye Hospital of Nanchang University (H.L)
| | - Qing Guo
- The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China (Q.G)
| | - Jizhe Cui
- The Second Hospital of Jilin University (J.C)
| | - Dan Zhu
- The Affiliated Hospital of Inner Mongolia Medical University (D.Z)
| | - Fang Lu
- West China Hospital, Sichuan University (F.L)
| | | | - Yu Wu
- People's Hospital of Guangxi Zhuang Autonomous Region (Y.W)
| | | | - Zhang Guanghong
- Beijing Road Clinical Department of Xinjiang Military Command General Hospital Urumqi (Z.G)
| | | | - Guo Huiyu
- Hainan Eye Hospital and Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University (G.H)
| | - Xian Wang
- The Affiliated Hospital of Guizhou Medical University (X.W)
| | - Yanjin He
- Tianjin medical university eye hospital (Y.H)
| | - Xunlun Sheng
- Ning Xia Eye Hospital, People's Hospital of Ningxia Hui Autonomous Region (X.S)
| | - Qing Wang
- Qinghai University Affiliated Hospital (Q.W)
| | - Jia Tan
- Department of Ophthalmology, Central South University Xiangya School of Medicine (S.W, J.T)
| | - Jianhong Liang
- Department of Ophthalmology, Peking University People's Hospital (J.L)
| | - Xiantao Sun
- Department of Ophthalmology, Henan Children's Hospital (X.S)
| | - Jing Zhang
- Department of Ophthalmology, Guangzhou Women and Children's Medical Center (Z.L, J.Z)
| | - Xunda Ji
- Department of Ophthalmology, Xinhua Hospital affiliated with Shanghai Jiaotong University School of Medicine (L.J)
| | - Liwen Jin
- Department of Ophthalmology, Quanzhou Women's and Children's Hospital (L.J)
| | - Junyang Zhao
- Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University (M.J, J.Z)
| | - Xinji Yang
- Department of Ophthalmology, The General Hospital of Chinese People's Armed Police Forces (X.Y)
| | - Renbing Jia
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, M.H, R.J, X.F); Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, R.J, X.F)
| | - Xianqun Fan
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, M.H, R.J, X.F); Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, R.J, X.F).
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20
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Reedijk AM, Beishuizen A, Coebergh JWW, Hoeben BA, Kremer LC, Hebeda KM, Pieters R, Loeffen JL, Karim-Kos HE. Progress against non-Hodgkin's lymphoma in children and young adolescents in the Netherlands since 1990: Stable incidence, improved survival and lower mortality. Eur J Cancer 2022; 163:140-151. [DOI: 10.1016/j.ejca.2021.12.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/06/2021] [Accepted: 12/06/2021] [Indexed: 12/22/2022]
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Mallon B, Kaboré R, Couitchere L, Akonde FB, Lukamba R, Dackono TA, Narison MLR, Khattab M, Pondy A, Fedhila Ben Ayed F, Budiongo A, Guedenon K, Oberlin O, Patte C. The development of an international childhood cancer hospital register database in 13 African countries. A project of the French African Pediatric Oncology Group (GFAOP). Pediatr Blood Cancer 2022; 69:e29464. [PMID: 34913572 DOI: 10.1002/pbc.29464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 10/11/2021] [Accepted: 10/26/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND AND AIM The establishment of an international hospital-based register (HBR) for the French African Pediatric Oncology Group (GFAOP) was a necessary step in the group's clinical research program. With help from the Sanofi Espoir Foundation's "My Child Matters" program, the GFAOP resolved to develop an international HBR network to collect quality data on children attending the Pediatric Oncology Units (POUs). METHODS All children entering POUs from January 2016 to December 2018 were registered using an online questionnaire. Data collection included information on diagnosis, disease stage, demographics, socioeconomic status, and outcome. An intensive training program was developed to improve both data quality and quantity. RESULTS Among the 3348 children registered, 3230 had a suspected cancer, 681 were not confirmed. A diagnosis was confirmed on radiological, clinical, or histological examination for 2549 children including Burkitt lymphoma (516: 20%)-the most frequent diagnosis, Wilms' tumor (459: 18%), retinoblastoma (357: 14%), and acute lymphoblastic leukemia (345: 13%). Of these, 2187 children were treated. Early deaths, abandonment, economic difficulties, and lack of equipment were some of the reasons offered to explain the numbers of undiagnosed and untreated children. Vital status is known for 1994 children: 1187 died and 807 were alive, 551 of these with a follow-up > 12 months. CONCLUSION This work has provided reliable data on children attending the POUs, especially clarifying reasons and occasions for care rupture. The data will help to identify material, human resources, and staff training needs, to evaluate progress, and to encourage consideration of pediatric cancer in national cancer plans.
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Affiliation(s)
| | - Rolande Kaboré
- Centre Hospitalier Universitaire Yalgado Ouédraogo, Ouagadougou, Burkina Faso
| | | | | | - Robert Lukamba
- Cliniques Universitaires de Lubumbashi (CUL) Democratic Republic of Congo (DRC)
| | | | | | | | - Angèle Pondy
- Centre Mère et Enfant de la Fondation Chantal Biya, Yaoundé, Cameroon
| | | | | | - Koffi Guedenon
- Unité d'oncologie pédiatrique, CHU Sylvanus Olympio, Lomé, Togo
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22
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Liubartas NC, Gascón TM, Filipini R, Fonseca FLA. Use of Peripherally Inserted Central Catheter as a Facilitator in the Juvenile
Cancer Therapeutic Process. CURRENT CANCER THERAPY REVIEWS 2022. [DOI: 10.2174/1573394717666210813125352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective:
The objective of this study is to analyze the characteristics of insertion and
maintenance of 163 peripherally inserted central venous catheters in juvenile patients oncological.
Methods:
This is an observational study of a cross-sectional and longitudinal collection, with quantitative
approach of secondary data from patient’s medical records that underwent the procedure
for a peripheral insertion central catheter implantation, carried out in a non-profit Health Institution
(HI) in Sao Paulo, Brazil, specialized in the treatment of childhood-juvenile cancer, and which attends
children and adolescents from all regions of Brazil.
Results:
The measurement of the external catheter, when greater than 2 centimeters, negatively influences
the period of the segment used (p = 0.007) and is associated with catheter removal for unforeseen
causes (p = 0.013); displacement was the main cause of unexpected removal of peripherally
inserted central venous catheter.
Conclusion:
Peripherally inserted central venous catheter is a safe option when the entire therapeutic
trajectory is reached.
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Affiliation(s)
- Natalia Cristina Liubartas
- Graduated in Nursing and Specializing in Pediatrics and Neonatology of ABC Medical School, Santo André, SP,
Brazil
| | - Thaís Moura Gascón
- Clinical Laboratory Analysis of ABC Medical School, Santo André, SP, Brazil
| | | | - Fernando Luiz Affonso Fonseca
- Department of Pharmaceutical Sciences, Federal University of São Paulo Clinical
Laboratory Analysis of ABC Medical School, Santo André, SP, Brazil
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Pedersen LH, Erdmann F, Aalborg GL, Hjalgrim LL, Larsen HB, Schmiegelow K, Winther JF, Dalton SO. Socioeconomic position and prediagnostic health care contacts in children with cancer in Denmark: a nationwide register study. BMC Cancer 2021; 21:1104. [PMID: 34649500 PMCID: PMC8518314 DOI: 10.1186/s12885-021-08837-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 09/30/2021] [Indexed: 11/28/2022] Open
Abstract
Background While underlying mechanisms and pathways of social inequalities in cancer survival have been extensively examined in adults, this is less so for children with cancer. Hypothesized mechanisms include prediagnostic utilization of and navigation through the health care system, which may differ by socioeconomic resources of the families. In this nationwide register-based study we investigated the association between measures of family socioeconomic position in relation to prediagnostic health care contacts and stage of disease at diagnosis in children with cancer in Denmark. Methods We identified all children diagnosed with a cancer at ages 0–15 years in 1998–2016 (N = 3043) from the Danish Childhood Cancer Registry. We obtained comprehensive information on measures of socioeconomic position, parental health and prediagnostic contacts to both general practitioners and hospitals 24 months prior to diagnosis from various national registries. We fitted multivariable conditional logistic regression models for the association of family socioeconomic and health-related variables with firstly, frequent health care contacts and secondly, advanced stage. Results We found higher odds ratios (OR) of frequent both overall and emergency health care contacts in the last 3 months before diagnosis in children from households with short parental education and mixed affiliation to work market, when compared to children with high family socioeconomic position. Further, children of parents with depression or of non-Western origin, respectively, had higher OR for frequent overall and emergency contacts. We found no association between socioeconomic position, parental health and stage of disease. Conclusion Families with socioeconomic disadvantage, non-Western origin or depression more frequently utilize prediagnostic health care services, both generally and in the acute setting, indicating that some disadvantaged families may struggle to navigate the health care system when their child is sick. Reassuringly, this was not reflected in disparities in stage at diagnosis. In order to improve the diagnostic process and potentially reduce health care contacts, attention and support should be given to families with a high number of health care contacts over a short period of time. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-08837-x.
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Affiliation(s)
- Line Hjøllund Pedersen
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen, Denmark. .,Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark.
| | - Friederike Erdmann
- Division of Childhood Cancer Epidemiology, Institute for Medical Biostatistics, Epidemiology and Informatics (IMBEI), Johannes Gutenberg University Mainz, Mainz, Germany
| | - Gitte Lerche Aalborg
- Statistics and Data Analysis, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Lisa Lyngsie Hjalgrim
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen, Denmark
| | - Hanne Bækgaard Larsen
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen, Denmark.,Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Kjeld Schmiegelow
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen, Denmark.,Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Susanne Oksbjerg Dalton
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark.,Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Oncology & Palliative Care, Zealand University Hospital, Naestved, Denmark
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Gatta G, Botta L, Capocaccia R, Cañete A, Pritchard-Jones K. Staging childhood cancers in Europe: Application of the Toronto stage principles for neuroblastoma and Wilms tumour. The JARC pilot study. Pediatr Blood Cancer 2021; 68:e29020. [PMID: 34114308 DOI: 10.1002/pbc.29020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 02/23/2021] [Accepted: 03/04/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND The 'Toronto consensus principles and guidelines' (TG) provided paediatric-specific staging system affordable by population-based cancer registries (CRs). Within the European Rare Cancers Joint Action, a pilot study of the application of TG for childhood cancer (CC) was conducted to test the ability of CRs to reconstruct stage, describe stage across countries and assess survival by stage. PROCEDURE Twenty-five CRs representing 15 countries contributed data on a representative sample of patients with neuroblastoma (NB) and Wilms tumour (WT) <15 years, diagnosed between 2000 and 2016. Outcome was calculated by Kaplan-Meier method and by Cox regression model. RESULTS Stage was reconstructed for 95% of cases. Around half of the children had localised or locoregional disease at diagnosis. The proportion of metastatic cases was 38% for NB and 13% for WT. Three-year survival was >90% for locoregional cases both of NB and WT, 58% for NB M-stage and 77% for WT stage-IV. Older age was associated with more advanced stage. CONCLUSIONS European CRs were able to reconstruct stage according to the TG. Stage should be included in the routine collection of variables. Stage information had clear prognostic value and should be used to investigate survival variations between countries or over time.
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Affiliation(s)
- Gemma Gatta
- Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Laura Botta
- Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | | | - Kathy Pritchard-Jones
- Developmental Biology and Cancer Programme, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
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25
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Poulalhon C, Goujon S, Marquant F, Faure L, Guissou S, Bonaventure A, Désandes E, Rios P, Lacour B, Clavel J. Factors associated with 5- and 10-year survival among a recent cohort of childhood cancer survivors (France, 2000-2015). Cancer Epidemiol 2021; 73:101950. [PMID: 34214767 DOI: 10.1016/j.canep.2021.101950] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 04/28/2021] [Accepted: 05/02/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Childhood cancer survival currently exceeds 80 % five years after diagnosis in high-income countries. In this study, we aimed to describe long-term trends and to investigate socioeconomic and spatial disparities in childhood cancer survival. METHODS The study included 28,073 cases recorded in the French National Registry of Childhood Cancers from 2000 to 2015. Contextual census data (deprivation indices, population density, spatial accessibility to general practitioners) were allocated to each case based on the residence at diagnosis. Overall survival (OS) and conditional 10-year OS for 5-year survivors were estimated for all cancers combined and by diagnostic group and subgroup. Comparisons were conducted by sex, age at diagnosis, period of diagnosis, and contextual indicators. Hazard ratios for death were estimated using Cox models. RESULTS All cancers combined, the OS reached 82.8 % [95 % CI: 82.4-83.3] at 5 years and 80.8 % [95 % CI: 80.3-81.3] at 10 years. Conditional 10-year OS of 5-year survivors reached 97.5 % [95 % CI: 97.3-97.7] and was higher than 95 % for all subgroups except osteosarcomas and most subgroups of the central nervous system. In addition to disparities by sex, age at diagnosis, and period of diagnosis, we observed a slight decrease in survival for cases living in the most deprived areas at diagnosis, not consistent across diagnostic groups. CONCLUSION Our results confirm the high 5-year survival for childhood cancer and show an excellent 10-year conditional survival of 5-year survivors. Additional individual data are needed to clarify the factors underlying the slight decrease in childhood cancer survival observed in the most deprived areas.
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Affiliation(s)
- Claire Poulalhon
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, France; Registre National des Cancers de l'Enfant, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris (AP-HP), Villejuif, and Centre Hospitalier Régional Universitaire de Nancy, Vandoeuvre-lès-Nancy, France.
| | - Stéphanie Goujon
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, France; Registre National des Cancers de l'Enfant, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris (AP-HP), Villejuif, and Centre Hospitalier Régional Universitaire de Nancy, Vandoeuvre-lès-Nancy, France
| | - Fabienne Marquant
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, France; Registre National des Cancers de l'Enfant, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris (AP-HP), Villejuif, and Centre Hospitalier Régional Universitaire de Nancy, Vandoeuvre-lès-Nancy, France
| | - Laure Faure
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, France; Registre National des Cancers de l'Enfant, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris (AP-HP), Villejuif, and Centre Hospitalier Régional Universitaire de Nancy, Vandoeuvre-lès-Nancy, France
| | - Sandra Guissou
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, France; Registre National des Cancers de l'Enfant, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris (AP-HP), Villejuif, and Centre Hospitalier Régional Universitaire de Nancy, Vandoeuvre-lès-Nancy, France
| | - Audrey Bonaventure
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, France
| | - Emmanuel Désandes
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, France; Registre National des Cancers de l'Enfant, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris (AP-HP), Villejuif, and Centre Hospitalier Régional Universitaire de Nancy, Vandoeuvre-lès-Nancy, France
| | - Paula Rios
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, France
| | - Brigitte Lacour
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, France; Registre National des Cancers de l'Enfant, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris (AP-HP), Villejuif, and Centre Hospitalier Régional Universitaire de Nancy, Vandoeuvre-lès-Nancy, France
| | - Jacqueline Clavel
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, France; Registre National des Cancers de l'Enfant, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris (AP-HP), Villejuif, and Centre Hospitalier Régional Universitaire de Nancy, Vandoeuvre-lès-Nancy, France
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26
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Peter N, Bandyopadhyay S, Lakhoo K. Impact of the COVID-19 pandemic on paediatric patients with cancer in low-income, middle-income and high-income countries: protocol for a multicentre, international, observational cohort study. BMJ Open 2021; 11:e045679. [PMID: 34083337 PMCID: PMC8182746 DOI: 10.1136/bmjopen-2020-045679] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Childhood cancers are a leading cause of non-communicable disease deaths for children around the world. The COVID-19 pandemic may have impacted on global children's cancer services, which can have consequences for childhood cancer outcomes. The Global Health Research Group on Children's Non-Communicable Diseases is currently undertaking the first international cohort study to determine the variation in paediatric cancer management during the COVID-19 pandemic, and the short-term to medium-term impacts on childhood cancer outcomes. METHODS AND ANALYSIS This is a multicentre, international cohort study that will use routinely collected hospital data in a deidentified and anonymised form. Patients will be recruited consecutively into the study, with a 12-month follow-up period. Patients will be included if they are below the age of 18 years and undergoing anticancer treatment for the following cancers: acute lymphoblastic leukaemia, Burkitt lymphoma, Hodgkin lymphoma, Wilms tumour, sarcoma, retinoblastoma, gliomas, medulloblastomas and neuroblastomas. Patients must be newly presented or must be undergoing active anticancer treatment from 12 March 2020 to 12 December 2020. The primary objective of the study was to determine all-cause mortality rates of 30 days, 90 days and 12 months. This study will examine the factors that influenced these outcomes. χ2 analysis will be used to compare mortality between low-income and middle-income countries and high-income countries. Multilevel, multivariable logistic regression analysis will be undertaken to identify patient-level and hospital-level factors affecting outcomes with adjustment for confounding factors. ETHICS AND DISSEMINATION At the host centre, this study was deemed to be exempt from ethical committee approval due to the use of anonymised registry data. At other centres, participating collaborators have gained local approvals in accordance with their institutional ethical regulations. Collaborators will be encouraged to present the results locally, nationally and internationally. The results will be submitted for publication in a peer-reviewed journal.
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Affiliation(s)
- Noel Peter
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | | | - Kokila Lakhoo
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
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27
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Parkin DM, Youlden DR, Chitsike I, Chokunonga E, Couitchéré L, Gnahatin F, Nambooze S, Wabinga H, Aitken JF. Stage at diagnosis and survival by stage for the leading childhood cancers in three populations of sub-Saharan Africa. Int J Cancer 2021; 148:2685-2691. [PMID: 33433927 DOI: 10.1002/ijc.33468] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 11/14/2020] [Accepted: 12/03/2020] [Indexed: 01/22/2023]
Abstract
The lack of accurate population-based information on childhood cancer stage and survival in low-income countries is a barrier to improving childhood cancer outcomes. In our study, data from three population-based registries in sub-Saharan Africa (Abidjan, Harare and Kampala) were examined for children aged under 15. We assessed the feasibility of assigning stage at diagnosis according to Tier 1 of the Toronto Childhood Cancer Stage Guidelines for patients with non-Hodgkin lymphoma [including Burkitt lymphoma (BL)], retinoblastoma and Wilms' tumour. Patients were actively followed-up, allowing calculation of 3-year relative survival by cancer type and registry. Stage-specific observed survival was estimated. The cohort comprised 381 children, of whom half (n = 192, 50%) died from any cause within 3 years of diagnosis. Three-year relative survival varied by malignancy and location and ranged from 17% [95% confidence interval (CI) = 6%-33%] for BL in Harare to 57% (95% CI = 31%-76%) for retinoblastoma in Kampala. Stage was assigned for 83% of patients (n = 317 of 381), with over half having metastatic or advanced disease at diagnosis (n = 166, 52%). Stage was a strong predictor of survival for each malignancy; for example, 3-year observed survival was 88% (95% CI = 68%-96%) and 13% (4%-29%) for localised and advanced BL, respectively (P < .001). These are the first data on stage distribution and stage-specific survival for childhood cancers in Africa. They demonstrate the feasibility of the Toronto Stage Guidelines in a low-resource setting and highlight the value of population-based cancer registries in aiding our understanding of the poor outcomes experienced by this population.
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Affiliation(s)
- Donald Maxwell Parkin
- Cancer Surveillance Unit, International Agency for Research on Cancer, Lyon, France
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
- African Cancer Registry Network, INCTR, Oxford, UK
| | - Danny R Youlden
- Cancer Council Queensland, Brisbane, Queensland, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Inam Chitsike
- Paediatric Heme-Oncology Unit, University of Zimbabwe, Harare, Zimbabwe
| | | | - Line Couitchéré
- Pediatric Unit, Teaching Hospital of Treichville, Félix Houphouët Boigny Université, Abidjan, Côte d'Ivoire
| | - Franck Gnahatin
- Registre du Cancer d'Abidjan (RCA), Programme National de Lutte contre le Cancer (PNLCa), Ministère de la Santé et de l'Hygiène Publique (MSHP), Abidjan, Côte d'Ivoire
| | - Sarah Nambooze
- Kampala Cancer Registry, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Henry Wabinga
- Department of Pathology, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Joanne F Aitken
- Cancer Council Queensland, Brisbane, Queensland, Australia
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
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28
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Poulalhon C, Vignon L, Idbrik L, Bernier-Chastagner V, Fabre M, Schleiermacher G, Dijoud F, Perrin C, Varlet P, Faure L, Guissou S, Désandes E, Hémon D, Berger C, Lacour B, Clavel J. Data Resource Profile: The French Childhood Cancer Observation Platform (CCOP). Int J Epidemiol 2021; 49:1434-1435k. [PMID: 32642766 DOI: 10.1093/ije/dyaa048] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 03/10/2020] [Indexed: 01/07/2023] Open
Affiliation(s)
- Claire Poulalhon
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, Paris, France.,Registre National des Cancers de l'Enfant, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris (AP-HP), Villejuif, and Centre Hospitalier Régional Universitaire de Nancy, Vandœuvre-lès-Nancy, France
| | - Lucie Vignon
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, Paris, France
| | - Latifa Idbrik
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, Paris, France
| | | | - Monique Fabre
- Service d'Anatomie et Cytologie Pathologiques, Hôpital Necker-Enfants Malades, AP-HP, and Faculté de Médecine, Université de Paris, Paris, France
| | | | - Frédérique Dijoud
- Service d'Anatomie et Cytologie Pathologiques, Groupement Hospitalier Est, Hospices Civils de Lyon, and Université Claude Bernard Lyon 1, Lyon, France
| | - Corinne Perrin
- Centre de Pathologie et de Neuropathologie Est, Hospices Civils de Lyon, Lyon, France
| | - Pascale Varlet
- Service de Neuropathologie, Hôpital Sainte-Anne, Groupe Hospitalier Universitaire Paris Psychiatrie et Neurosciences, and Université de Paris, Sorbonne Paris Cité, Paris, France
| | - Laure Faure
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, Paris, France.,Registre National des Cancers de l'Enfant, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris (AP-HP), Villejuif, and Centre Hospitalier Régional Universitaire de Nancy, Vandœuvre-lès-Nancy, France
| | - Sandra Guissou
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, Paris, France.,Registre National des Cancers de l'Enfant, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris (AP-HP), Villejuif, and Centre Hospitalier Régional Universitaire de Nancy, Vandœuvre-lès-Nancy, France
| | - Emmanuel Désandes
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, Paris, France.,Registre National des Cancers de l'Enfant, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris (AP-HP), Villejuif, and Centre Hospitalier Régional Universitaire de Nancy, Vandœuvre-lès-Nancy, France
| | - Denis Hémon
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, Paris, France
| | - Claire Berger
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, Paris, France.,Service d'Hématologie-Oncologie Pédiatrique, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Priest-en-Jarez, France
| | - Brigitte Lacour
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, Paris, France.,Registre National des Cancers de l'Enfant, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris (AP-HP), Villejuif, and Centre Hospitalier Régional Universitaire de Nancy, Vandœuvre-lès-Nancy, France
| | - Jacqueline Clavel
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, Paris, France.,Registre National des Cancers de l'Enfant, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris (AP-HP), Villejuif, and Centre Hospitalier Régional Universitaire de Nancy, Vandœuvre-lès-Nancy, France
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Piñeros M, Mery L, Soerjomataram I, Bray F, Steliarova-Foucher E. Scaling Up the Surveillance of Childhood Cancer: A Global Roadmap. J Natl Cancer Inst 2021; 113:9-15. [PMID: 32433739 PMCID: PMC7781445 DOI: 10.1093/jnci/djaa069] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 03/20/2020] [Accepted: 05/12/2020] [Indexed: 12/12/2022] Open
Abstract
The World Health Organization recently launched the Global Initiative for Childhood Cancer aiming to substantially increase survival among children with cancer by 2030. The ultimate goal concerns particularly less developed countries where survival estimates are considerably lower than in high-income countries where children with cancer attain approximately 80% survival. Given the vast gap in high-quality data availability between more and less developed countries, measuring the success of the Global Initiative for Childhood Cancer will also require substantial support to childhood cancer registries to enable them to provide survival data at the population level. Based on our experience acquired at the International Agency for Research on Cancer in global cancer surveillance, we hereby review crucial aspects to consider in the development of childhood cancer registration and present our vision on how the Global Initiative for Cancer Registry Development can accelerate the measurement of the outcome of children with cancer.
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Affiliation(s)
- Marion Piñeros
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Les Mery
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Isabelle Soerjomataram
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Freddie Bray
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Eva Steliarova-Foucher
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
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Gupta S, Aitken J, Bartels U, Bhakta N, Bucurenci M, Brierley JD, De Camargo B, Chokunonga E, Clymer J, Coza D, Fraser C, Fuentes-Alabi S, Gatta G, Gross T, Jakab Z, Kohler B, Kutluk T, Moreno F, Nakata K, Nur S, Parkin DM, Penberthy L, Pole J, Poynter JN, Pritchard-Jones K, Ramirez O, Renner L, Steliarova-Foucher E, Sullivan M, Swaminathan R, Van Eycken L, Vora T, Frazier AL. Development of paediatric non-stage prognosticator guidelines for population-based cancer registries and updates to the 2014 Toronto Paediatric Cancer Stage Guidelines. Lancet Oncol 2020; 21:e444-e451. [PMID: 32888473 DOI: 10.1016/s1470-2045(20)30320-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 05/13/2020] [Accepted: 05/19/2020] [Indexed: 12/24/2022]
Abstract
Population-based cancer registries (PBCRs) generate measures of cancer incidence and survival that are essential for cancer surveillance, research, and cancer control strategies. In 2014, the Toronto Paediatric Cancer Stage Guidelines were developed to standardise how PBCRs collect data on the stage at diagnosis for childhood cancer cases. These guidelines have been implemented in multiple jurisdictions worldwide to facilitate international comparative studies of incidence and outcome. Robust stratification by risk also requires data on key non-stage prognosticators (NSPs). Key experts and stakeholders used a modified Delphi approach to establish principles guiding paediatric cancer NSP data collection. With the use of these principles, recommendations were made on which NSPs should be collected for the major malignancies in children. The 2014 Toronto Stage Guidelines were also reviewed and updated where necessary. Wide adoption of the resultant Paediatric NSP Guidelines and updated Toronto Stage Guidelines will enhance the harmonisation and use of childhood cancer data provided by PBCRs.
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Affiliation(s)
- Sumit Gupta
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada.
| | | | - Ute Bartels
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Nickhill Bhakta
- Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | | | - James D Brierley
- Radiation Medicine Program, Princess Margaret Hospital, Toronto, ON, Canada
| | - Beatriz De Camargo
- Research Centre, National Cancer Institute National Cancer Institute, Rio de Janeiro, Brazil
| | | | - Jessica Clymer
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA
| | - Dana Coza
- Romanian National Child Cancer Registry, Constanta, Romania
| | - Chris Fraser
- Department of Oncology, Children's Health Queensland Hospital, South Brisbane, QLD, Australia
| | | | | | - Thomas Gross
- National Cancer Institute, National Institute of Health, Bethesda, MD, USA
| | - Zsuzsanna Jakab
- Hungarian Childhood Cancer Registry, Semmelweis University, Budapest, Hungary
| | - Betsy Kohler
- North American Association of Central Cancer Registries, Springfield, IL, USA
| | - Tezer Kutluk
- Department of Paediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute, Ankara, Turkey
| | | | - Kayo Nakata
- Cancer Control Centre, Osaka International Cancer Institute, Osaka, Japan
| | - Sari Nur
- Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Jawa Barat, Indonesia
| | - D M Parkin
- Nuffield Department of Population Health, University of Oxford, Oxford, UK; Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Lynne Penberthy
- National Cancer Institute, National Institute of Health, Bethesda, MD, USA
| | - Jason Pole
- Pediatric Group of Ontario, Toronto, ON, Canada
| | - Jenny N Poynter
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | | | - Oscar Ramirez
- Centro Médico Imbanaco, Cali, Valle del Cauca, Colombia
| | - Lorna Renner
- University of Ghana School of Medicine, Accra, Ghana
| | - Eva Steliarova-Foucher
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Michael Sullivan
- Faculty of Medicine, University of Melbourne, Parkville, VIC, Australia
| | | | | | - Tushar Vora
- Tata Memorial Centre, Mumbai, Maharashtra, India
| | - A L Frazier
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA
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Sacerdote C, Mosso ML, Alessi D, Merletti F, Tagliabue G, D'Agostino A, Fabiano S, Savoia F, Piga P, Sessa M, Vetrano F, Gatta G, Maule M. An application of the Toronto Childhood Cancer Stage Guidelines in three population-based cancer registries: The case of central nervous tumors. Pediatr Blood Cancer 2020; 67:e28303. [PMID: 32301558 DOI: 10.1002/pbc.28303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 03/11/2020] [Accepted: 03/16/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND Cancer stage is a determinant of survival of childhood central nervous system (CNS) cancers and could help the interpretation of survival variability among countries. Consensus guidelines to stage childhood malignancies in population cancer registries ("Toronto Childhood Cancer Stage Guidelines") have been recently proposed with the goal of data comparability. Indeed, stage is not systematically recorded in all registries and, when it is, different classification systems are used. We applied the Toronto Childhood Cancer Stage Guidelines to CNS cancer cases of three population-based cancer registries with the aim of evaluating the feasibility of staging this type of cancer and the critical points in the classification of CNS tumors. PROCEDURES The Toronto Childhood Cancer Stage Guidelines were applied to 175 CNS patients, diagnosed from January 1, 2002 to December 31, 2014 in three cancer registries in Italy, and the percentage of cases that could be staged was assessed. RESULTS One hundred eight of 126 (86%) medulloblastomas and other embryonal CNS cancers and 22 of 49 (45%) ependymomas were staged. Using these guidelines, survival of children with localized tumors could be discriminated from that of children with metastatic disease. CONCLUSIONS The use of the Toronto Childhood Cancer Stage Guidelines is feasible for staging medulloblastoma in Italian population-based cancer registries, whereas it is more difficult for ependymomas. In Italy, cerebrospinal fluid examination, one of the decisive tests to stage CNS tumors, is not routinely performed as a first-line diagnosis procedure in ependymoma pediatric patients. A similar exercise by a larger number of cancer registries in different countries could suggest improvements in the childhood cancer staging system.
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Affiliation(s)
- Carlotta Sacerdote
- Unit of Cancer Epidemiology, Citta' della Salute e della Scienza Hospital and Centre for Cancer Prevention, Turin, Italy.,Department of Medical Sciences, University of Turin, Turin, Italy
| | | | - Daniela Alessi
- Unit of Cancer Epidemiology, Citta' della Salute e della Scienza Hospital and Centre for Cancer Prevention, Turin, Italy
| | - Franco Merletti
- Unit of Cancer Epidemiology, Citta' della Salute e della Scienza Hospital and Centre for Cancer Prevention, Turin, Italy.,Department of Medical Sciences, University of Turin, Turin, Italy
| | - Giovanna Tagliabue
- Lombardy Cancer Registry, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Anna D'Agostino
- Lombardy Cancer Registry, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Sabrina Fabiano
- Lombardy Cancer Registry, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Fabio Savoia
- Childhood Cancer Registry of Campania, AORN Santobono-Pausilipon, Naples, Italy
| | - Patrizia Piga
- Childhood Cancer Registry of Campania, AORN Santobono-Pausilipon, Naples, Italy
| | - Marcella Sessa
- Childhood Cancer Registry of Campania, AORN Santobono-Pausilipon, Naples, Italy
| | - Francesco Vetrano
- Childhood Cancer Registry of Campania, AORN Santobono-Pausilipon, Naples, Italy
| | - Gemma Gatta
- Evaluative Epidemiology Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | - Milena Maule
- Unit of Cancer Epidemiology, Citta' della Salute e della Scienza Hospital and Centre for Cancer Prevention, Turin, Italy.,Department of Medical Sciences, University of Turin, Turin, Italy
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Erdmann F, Frederiksen LE, Bonaventure A, Mader L, Hasle H, Robison LL, Winther JF. Childhood cancer: Survival, treatment modalities, late effects and improvements over time. Cancer Epidemiol 2020; 71:101733. [PMID: 32461035 DOI: 10.1016/j.canep.2020.101733] [Citation(s) in RCA: 120] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 04/01/2020] [Accepted: 04/27/2020] [Indexed: 12/31/2022]
Abstract
Since the 1960s, paediatric oncologists have gradually become better organised in large study groups and participation in clinical trials is today considered as the standard of care, with most children with cancer in Europe and North America being enrolled on available treatment protocols. Chemotherapy is nowadays the main element of therapy, but irradiation is still required for some patients. With the advent of multimodality therapy and supportive care, five-year cancer survival exceeds 80 % in most European and North American countries today. The substantial improvements in survival led to a constantly growing population of childhood cancer survivors. Concerns regarding the risk of late effects of the intensive cancer treatment at a young age, together with increasing numbers of survivors, have directed attention towards survivorship research. Survivors of childhood cancer are at longstanding risk of various severe somatic and mental health conditions attributable to the cancer and its treatment, as well as adverse social and socioeconomic consequences, and diminished psychological well-being and quality of life. It is, however, important to stress that some survivors have no or very mild adverse health conditions. Nevertheless, joint efforts are warranted for the care and long-term follow-up of childhood cancer patients. With this article, we provide a comprehensive overview of improvements in survival and treatment modalities over time, as well as the related somatic and mental late effects, and social and socioeconomic difficulties that these children might encounter later in life.
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Affiliation(s)
- Friederike Erdmann
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Denmark; German Childhood Cancer Registry, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Germany.
| | | | - Audrey Bonaventure
- Epidemiology of Childhood and Adolescent Cancer Team, Centre of Research in Epidemiology and Statistics, University of Paris, UMR 1153 INSERM, France
| | - Luzius Mader
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Denmark; Institute of Social and Preventive Medicine (ISPM), University of Bern, Switzerland
| | - Henrik Hasle
- Department of Paediatrics, Aarhus University Hospital, Denmark
| | - Leslie L Robison
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, 38105, United States
| | - Jeanette Falck Winther
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Denmark; Department of Clinical Medicine, Faculty of Health, Aarhus University and University Hospital, Denmark
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Ou JY, Hanson HA, Ramsay JM, Kaddas HK, Pope CA, Leiser CL, VanDerslice J, Kirchhoff AC. Fine Particulate Matter Air Pollution and Mortality among Pediatric, Adolescent, and Young Adult Cancer Patients. Cancer Epidemiol Biomarkers Prev 2020; 29:1929-1939. [PMID: 32404444 DOI: 10.1158/1055-9965.epi-19-1363] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 01/28/2020] [Accepted: 03/03/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Air pollution is a carcinogen and causes pulmonary and cardiac complications. We examined the association of fine particulate matter pollution (PM2.5) and mortality from cancer and all causes among pediatric, adolescent, and young adult (AYA) patients with cancer in Utah, a state with considerable variation in PM2.5. METHODS We followed 2,444 pediatric (diagnosed ages 0-14) and 13,459 AYA (diagnosed ages 15-39) patients diagnosed in 1986-2015 from diagnosis to 5 and 10 years postdiagnosis, death, or emigration. We measured average monthly PM2.5 by ZIP code during follow-up. Separate pediatric and AYA multivariable Cox models estimated the association of PM2.5 and mortality. Among AYAs, we examined effect modification of PM2.5 and mortality by stage while controlling for cancer type. RESULTS Increases in PM2.5 per 5 μg/m3 were associated with cancer mortality in pediatric lymphomas and central nervous system (CNS) tumors at both time points, and all cause mortality in lymphoid leukemias [HR5-year = 1.32 (1.02-1.71)]. Among AYAs, PM2.5 per 5 μg/m3 was associated with cancer mortality in CNS tumors and carcinomas at both time points, and all cause mortality for all AYA cancer types [HR5-year = 1.06 (1.01-1.13)]. PM2.5 ≥12 μg/m3 was associated with cancer mortality among breast [HR5-year = 1.50 (1.29-1.74); HR10-year = 1.30 (1.13-1.50)] and colorectal cancers [HR5-year = 1.74 (1.29-2.35); HR10-year = 1.67 (1.20-2.31)] at both time points. Effect modification by stage was significant, with local tumors at highest risk. CONCLUSIONS PM2.5 was associated with mortality in pediatric and AYA patients with specific cancers. IMPACT Limiting PM2.5 exposure may be important for young cancer patients with certain cancers.See all articles in this CEBP Focus section, "Environmental Carcinogenesis: Pathways to Prevention."
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Affiliation(s)
- Judy Y Ou
- Huntsman Cancer Institute, Cancer Control and Population Sciences, University of Utah, Salt Lake City, Utah.
| | - Heidi A Hanson
- Huntsman Cancer Institute, Cancer Control and Population Sciences, University of Utah, Salt Lake City, Utah
- Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah
| | - Joemy M Ramsay
- Huntsman Cancer Institute, Cancer Control and Population Sciences, University of Utah, Salt Lake City, Utah
| | - Heydon K Kaddas
- Huntsman Cancer Institute, Cancer Control and Population Sciences, University of Utah, Salt Lake City, Utah
| | | | - Claire L Leiser
- Huntsman Cancer Institute, Cancer Control and Population Sciences, University of Utah, Salt Lake City, Utah
- Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, Utah
| | - James VanDerslice
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Anne C Kirchhoff
- Huntsman Cancer Institute, Cancer Control and Population Sciences, University of Utah, Salt Lake City, Utah
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah
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Delavar A, Barnes JM, Wang X, Johnson KJ. Associations Between Race/Ethnicity and US Childhood and Adolescent Cancer Survival by Treatment Amenability. JAMA Pediatr 2020; 174:428-436. [PMID: 32091555 PMCID: PMC7042928 DOI: 10.1001/jamapediatrics.2019.6074] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
IMPORTANCE Although US cancer survival rates have increased over time, disparities by race/ethnicity remain, including for children and adolescents. OBJECTIVE To examine whether racial/ethnic disparities in childhood and adolescent cancer survival vary by cancer type according to relative survival rates (RSRs), a marker for amenability to medical intervention. DESIGN, SETTING, AND PARTICIPANTS In a retrospective cohort study using US Surveillance, Epidemiology, and End Results data, 67 061 children and adolescents diagnosed at ages 0 to 19 years with a first primary malignant cancer from January 1, 2000, to December 31, 2016, were evaluated. Data analysis was performed from June 19 to November 3, 2019. Participants were followed up from the dates of diagnosis to cancer death or the end of the follow-up period, whichever came first. EXPOSURES Race/ethnicity defined as non-Hispanic white, non-Hispanic black, non-Hispanic American Indian/Alaskan Native, non-Hispanic Asian or Pacific Islander, or Hispanic (any race). MAIN OUTCOMES AND MEASURES Cancer amenability was defined using 5-year RSRs for 103 cancer types. Cox proportional hazards regression was used to compute adjusted hazard ratios (aHRs) and 95% CIs for the association between race/ethnicity and cancer survival for high (>85% RSR), medium (70%-85% RSR), and low (<70% RSR) amenability categories. RESULTS Among 67 061 cancer cases, 36 064 were male (53.8%); most individuals were non-Hispanic white (35 186 [52.5%]) followed by Hispanic of any race (19 220 [28.7%]), non-Hispanic black (7100 [10.6%]), non-Hispanic Asian or Pacific Islander (4981 [7.4%]), and non-Hispanic American Indian/Alaskan Native (574 [0.9%]). Mean (SD) age at diagnosis was 9.66 (6.41) years. Compared with non-Hispanic white children and adolescents, a higher aHR of death was observed for high- than low-amenability cancers for non-Hispanic black patients (high: aHR, 1.59; 95% CI, 1.41-1.80 vs low: aHR, 1.35; 95% CI, 1.24-1.47; P = .002 for interaction) and Hispanic (any race) patients (high: aHR, 1.63; 95% CI, 1.50-1.78 vs low: aHR, 1.16; 95% CI, 1.08-1.25; P < .001 for interaction). Results for other race/ethnicities showed similar patterns but were not statistically significant. CONCLUSIONS AND RELEVANCE Racial/ethnic minority children and adolescents were observed to have a higher risk of death than non-Hispanic white children and adolescents, with more amenable cancers having larger relative survival differences. This disparity may be associated with a combination of factors, including differences in access to health care resources.
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Affiliation(s)
- Arash Delavar
- Medical Student, University of California, San Diego, School of Medicine, La Jolla,Brown School Master of Public Health Program, Washington University in St Louis, St Louis, Missouri
| | - Justin M. Barnes
- Medical Student, St Louis University School of Medicine, St Louis, Missouri
| | - Xiaoyan Wang
- Brown School Master of Public Health Program, Washington University in St Louis, St Louis, Missouri
| | - Kimberly J. Johnson
- Brown School Master of Public Health Program, Washington University in St Louis, St Louis, Missouri,Siteman Cancer Center, Washington University in St Louis, St Louis, Missouri
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35
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Paapsi K, Baburin A, Mikkel S, Mägi M, Saks K, Innos K. Childhood cancer incidence and survival trends in Estonia (1970-2016): a nationwide population-based study. BMC Cancer 2020; 20:30. [PMID: 31924184 PMCID: PMC6954517 DOI: 10.1186/s12885-019-6510-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 12/30/2019] [Indexed: 12/19/2022] Open
Abstract
Background Childhood cancers represent a small proportion of all cancers but are still a major public health problem. The study analysed long-term trends in childhood cancer incidence and survival in Estonia in relation to societal and health care transition. Methods Data on all malignant tumours, diagnosed in children aged 0–14 during 1970–2016, were derived from the Estonian Cancer Registry. Age-standardised (World standard) incidence rates were calculated by ICCC-3 site groups and joinpoint regression was used to estimate annual percentage change (APC) for incidence trends. Cohort and period approach were used to estimate 5-year survival. Internal age standardisation was applied. Results A total of 1628 incident cancer cases were diagnosed during the study period and overall incidence increased significantly at a rate of 0.5% per year. Significant increases were seen for neuroblastoma and germ cell tumours, for lymphoid leukemias and some CNS sub-sites. At the same time, decline in incidence was seen in almost all subgroups of unspecified neoplasms. The overall 5-year survival improved from 24% in 1970–1979 to 73% in 2010–2016, with the largest changes occurring in the 1990s and 2000s. For many sites, survival increase thereafter has been marginal. Conclusion In this first comprehensive population-based study of childhood cancer incidence and survival in Estonia, long-term trends are shown in the context of societal and health care changes. Even though the increasing incidence of some sites may, at least partially, be explained by improved diagnostics reflected in the decreased incidence of unspecified neoplasms, the overall cancer incidence in children seems to be rising. Rapid progress in diagnosis and care have improved childhood cancer survival immensely, but deficit in Estonia persists compared to other European countries. Results of the study accentuate the need for a more in-depth analysis of clinical data, but also for the prioritization of childhood cancer in Estonia, to ensure access to standard care and innovative treatments.
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Affiliation(s)
- Keiu Paapsi
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Hiiu 42, 11619, Tallinn, Estonia.
| | - Aleksei Baburin
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Hiiu 42, 11619, Tallinn, Estonia
| | - Sirje Mikkel
- Clinic of Haematology and Oncology, Tartu University Hospital, Tartu, Estonia
| | - Margit Mägi
- Estonian Cancer Registry, National Institute for Health Development, Tallin, Estonia
| | - Kadri Saks
- Department of Oncology and Haematology, Clinic of Paediatrics, Tallinn Children's Hospital, Tallinn, Estonia
| | - Kaire Innos
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Hiiu 42, 11619, Tallinn, Estonia
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36
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The global burden of childhood and adolescent cancer in 2017: an analysis of the Global Burden of Disease Study 2017. Lancet Oncol 2019; 20:1211-1225. [PMID: 31371206 PMCID: PMC6722045 DOI: 10.1016/s1470-2045(19)30339-0] [Citation(s) in RCA: 194] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 04/25/2019] [Accepted: 05/07/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Accurate childhood cancer burden data are crucial for resource planning and health policy prioritisation. Model-based estimates are necessary because cancer surveillance data are scarce or non-existent in many countries. Although global incidence and mortality estimates are available, there are no previous analyses of the global burden of childhood cancer represented in disability-adjusted life-years (DALYs). METHODS Using the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 methodology, childhood (ages 0-19 years) cancer mortality was estimated by use of vital registration system data, verbal autopsy data, and population-based cancer registry incidence data, which were transformed to mortality estimates through modelled mortality-to-incidence ratios (MIRs). Childhood cancer incidence was estimated using the mortality estimates and corresponding MIRs. Prevalence estimates were calculated by using MIR to model survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated by multiplying age-specific cancer deaths by the difference between the age of death and a reference life expectancy. DALYs were calculated as the sum of YLLs and YLDs. Final point estimates are reported with 95% uncertainty intervals. FINDINGS Globally, in 2017, there were 11·5 million (95% uncertainty interval 10·6-12·3) DALYs due to childhood cancer, 97·3% (97·3-97·3) of which were attributable to YLLs and 2·7% (2·7-2·7) of which were attributable to YLDs. Childhood cancer was the sixth leading cause of total cancer burden globally and the ninth leading cause of childhood disease burden globally. 82·2% (82·1-82·2) of global childhood cancer DALYs occurred in low, low-middle, or middle Socio-demographic Index locations, whereas 50·3% (50·3-50·3) of adult cancer DALYs occurred in these same locations. Cancers that are uncategorised in the current GBD framework comprised 26·5% (26·5-26·5) of global childhood cancer DALYs. INTERPRETATION The GBD 2017 results call attention to the substantial burden of childhood cancer globally, which disproportionately affects populations in resource-limited settings. The use of DALY-based estimates is crucial in demonstrating that childhood cancer burden represents an important global cancer and child health concern. FUNDING Bill & Melinda Gates Foundation, American Lebanese Syrian Associated Charities (ALSAC), and St. Baldrick's Foundation.
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Gupta S, Frazier AL, Aitken JF. Reply to Letter to the Editor "Staging of acute leukemia based on central nervous system involvement alone: Is it appropriate?". Pediatr Blood Cancer 2019; 66:e27756. [PMID: 31012523 DOI: 10.1002/pbc.27756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 04/02/2019] [Indexed: 11/06/2022]
Affiliation(s)
- Sumit Gupta
- Division of Haematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada.,Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - A Lindsay Frazier
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Boston, Massachusetts
| | - Joanne F Aitken
- Cancer Council Queensland, Brisbane, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Institute for Resilient Regions, University of Southern Queensland, Brisbane, Queensland, Australia.,School of Public Health, University of Queensland, Brisbane, Queensland, Australia
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38
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Totadri S, Bansal D. Staging of acute leukemia based on central nervous system involvement alone: Is it appropriate? Pediatr Blood Cancer 2019; 66:e27730. [PMID: 30900807 DOI: 10.1002/pbc.27730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 03/12/2019] [Indexed: 12/28/2022]
Affiliation(s)
- Sidharth Totadri
- Pediatric Hematology-Oncology Unit, Department of Pediatrics, Advanced Pediatrics Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Deepak Bansal
- Pediatric Hematology-Oncology Unit, Department of Pediatrics, Advanced Pediatrics Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Youlden DR, Gupta S, Frazier AL, Moore AS, Baade PD, Valery PC, Green AC, Aitken JF. Stage at diagnosis for children with blood cancers in Australia: Application of the Toronto Paediatric Cancer Stage Guidelines in a population-based national childhood cancer registry. Pediatr Blood Cancer 2019; 66:e27683. [PMID: 30803139 DOI: 10.1002/pbc.27683] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 10/22/2018] [Accepted: 11/26/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND Information on stage at diagnosis for childhood blood cancers is essential for surveillance but is not available on a population basis in most countries. Our aim was to apply the internationally endorsed Toronto Paediatric Cancer Stage Guidelines to children (<15 years) with acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), Hodgkin lymphoma (HL), or non-Hodgkin lymphoma (NHL) and to assess differences in survival by stage at diagnosis. PROCEDURE Stage was defined by extent of involvement of the central nervous system (CNS) for ALL and AML and using the Ann Arbor and St Jude-Murphy systems for HL and NHL, respectively. The study cohort was drawn from the population-based Australian Childhood Cancer Registry, consisting of children diagnosed with one of these four blood cancers between 2006 and 2014 with follow-up to 2015. Five-year observed survival was estimated from the Kaplan-Meier method. RESULTS Stage was assigned to 2201 of 2351 eligible patients (94%), ranging from 85% for AML to 95% for ALL, HL, and NHL. Survival following ALL varied from 94% (95% CI = 93%-95%) for CNS1 disease to 89% (95% CI = 79%-94%) for CNS2 (P = 0.07), whereas for AML there was essentially no difference in survival between CNS- (77%) and CNS+ disease (78%; P = 0.94). Nearly all children with HL survived for five years. There was a trend (P = 0.04) toward worsening survival with higher stage for NHL. CONCLUSIONS These results provide the first population-wide picture of the distribution and outcomes for childhood blood cancers in Australia by extent of disease at diagnosis and provide a baseline for future comparisons.
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Affiliation(s)
- Danny R Youlden
- Cancer Council Queensland, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Sumit Gupta
- Division of Haematology/Oncology, Hospital for Sick Children, Toronto, Canada.,Faculty of Medicine, University of Toronto, Toronto, Canada
| | - A Lindsay Frazier
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts
| | - Andrew S Moore
- The University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Queensland, Australia.,Oncology Services Group, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia.,UQ Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Peter D Baade
- Cancer Council Queensland, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.,School of Mathematical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Patricia C Valery
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Adèle C Green
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.,CRUK Manchester Institute and Division of Musculoskeletal and Dermatological Sciences, University of Manchester, Manchester, United Kingdom
| | - Joanne F Aitken
- Cancer Council Queensland, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.,Institute for Resilient Regions, University of Southern Queensland, Brisbane, Queensland, Australia.,School of Public Health, University of Queensland, Brisbane, Queensland, Australia
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40
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Gatta G, Botta L, Comber H, Dimitrova N, Leinonen MK, Pritchard-Jones K, Siesling S, Trama A, Van Eycken L, van der Zwan JM, Visser O, Zagar T, Capocaccia R. The European study on centralisation of childhood cancer treatment. Eur J Cancer 2019; 115:120-127. [PMID: 31132742 DOI: 10.1016/j.ejca.2019.04.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 03/25/2019] [Accepted: 04/02/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND It is generally agreed to centralise treatment of childhood cancers (CCs). We analysed (1) the degree of centralisation of CCs in European countries and 2) the relations between centralisation and survival. PATIENTS AND METHODS The analysis comprised 4415 CCs, diagnosed between 2000 and 2007 and followed up to the end of 2013, from Belgium, Bulgaria, Finland, Ireland, the Netherlands and Slovenia. All these countries had national population-based cancer registries and were able to provide information on diagnosis, treatment, treatment hospitals, and survival. Each case was then classified according to whether the patient was treated in a high- or a low-volume hospital among those providing CC treatment. A Cox proportional hazard model was used to calculate the relation between volume category and five-year survival, adjusting by age, sex and diagnostic group. RESULTS The number of hospitals providing treatment for CCs ranged from six (Slovenia) to slightly more than 40 (the Netherlands and Belgium). We identified a single higher volume hospital in Ireland and in Slovenia, treating 80% and 97% of cases, respectively, and three to five major hospitals in the other countries, treating between 65% and 93% of cases. Outcome was significantly better when primary treatment was given in high-volume hospitals compared to low-volume hospitals for central nervous system tumours (relative risk [RR] = 0.71), haematologic tumours (RR = 0.74) and for all CC combined (RR = 0.83). CONCLUSION Treatment centralisation is associated with survival benefits and should be further strengthened in these countries. New plans for centralisation should include ongoing evaluation.
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Affiliation(s)
- G Gatta
- Evaluative Epidemiology Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy.
| | - L Botta
- Evaluative Epidemiology Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | - H Comber
- National Cancer Registry Ireland, Cork, Ireland
| | - N Dimitrova
- Bulgarian National Cancer Registry, Sofia, Bulgaria
| | - M K Leinonen
- Cancer Society of Finland, Finnish Cancer Registry, Helsinki, Finland
| | - K Pritchard-Jones
- Developmental Biology and Cancer Programme, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - S Siesling
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
| | - A Trama
- Evaluative Epidemiology Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | | | - J M van der Zwan
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
| | - O Visser
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
| | - T Zagar
- Institute of Oncology Ljubljana, Epidemiology and Cancer Registry, Ljubljana, Slovenia
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Stage at diagnosis for childhood solid cancers in Australia: A population-based study. Cancer Epidemiol 2019; 59:208-214. [DOI: 10.1016/j.canep.2019.02.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 02/12/2019] [Accepted: 02/16/2019] [Indexed: 12/17/2022]
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Piñeros M, Parkin DM, Ward K, Chokunonga E, Ervik M, Farrugia H, Gospodarowicz M, O'Sullivan B, Soerjomataram I, Swaminathan R, Znaor A, Bray F, Brierley J. Essential TNM: a registry tool to reduce gaps in cancer staging information. Lancet Oncol 2019; 20:e103-e111. [PMID: 30712797 DOI: 10.1016/s1470-2045(18)30897-0] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 11/20/2018] [Accepted: 11/20/2018] [Indexed: 01/09/2023]
Abstract
Accurate information on the extent of disease around the time of diagnosis is an important component of cancer care, in defining disease prognosis, and evaluating national and international cancer control policies. However, the collection of stage data by population-based cancer registries remains a challenge in both high-income and low and middle-income countries. We emphasise the lack of availability and comparability of staging information in many population-based cancer registries and propose Essential TNM, a simplified staging system for cancer registries when information on full Tumour, Node, Metastasis (TNM) is absent. Essential TNM aims at staging cancer in its most advanced disease form by summarising the extent of disease in the order of distant metastasis (M), regional lymph node involvement (N), and tumour size or extension, or both (T). Flowcharts and rules have been developed for coding these elements in breast, cervix, prostate, and colon cancers, and combining them into stage groups (I-IV) that correspond to those obtained by full TNM staging. Essential TNM is comparable to the Union for International Cancer Control TNM stage groups and is an alternative to providing staging information by the population-based cancer registries that complies with the objectives of the Global Initiative for Cancer Registry Development.
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Affiliation(s)
- Marion Piñeros
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France.
| | - D Maxwell Parkin
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France; African Cancer Registry Network, Oxford, England
| | - Kevin Ward
- Georgia Center for Cancer Statistics, Atlanta, GA, USA; Board of Directors, International Association of Cancer Registries, Lyon, France
| | | | - Morten Ervik
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Helen Farrugia
- Victorian Cancer Registry, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Mary Gospodarowicz
- Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada; Union for International Cancer Control, Geneva, Switzerland
| | - Brian O'Sullivan
- Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada; Union for International Cancer Control, Geneva, Switzerland
| | - Isabelle Soerjomataram
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Rajaraman Swaminathan
- Division of Epidemiology, Biostatistics and Cancer Registry, Cancer Institute (WIA), Chennai, Tamil Nadu, India
| | - Ariana Znaor
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Freddie Bray
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - James Brierley
- Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada; Union for International Cancer Control, Geneva, Switzerland
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Bhakta N, Force LM, Allemani C, Atun R, Bray F, Coleman MP, Steliarova-Foucher E, Frazier AL, Robison LL, Rodriguez-Galindo C, Fitzmaurice C. Childhood cancer burden: a review of global estimates. Lancet Oncol 2019; 20:e42-e53. [PMID: 30614477 DOI: 10.1016/s1470-2045(18)30761-7] [Citation(s) in RCA: 219] [Impact Index Per Article: 43.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 10/04/2018] [Accepted: 10/08/2018] [Indexed: 12/18/2022]
Abstract
5-year net survival of children and adolescents diagnosed with cancer is approximately 80% in many high-income countries. This estimate is encouraging as it shows the substantial progress that has been made in the diagnosis and treatment of childhood cancer. Unfortunately, scarce data are available for low-income and middle-income countries (LMICs), where nearly 90% of children with cancer reside, suggesting that global survival estimates are substantially worse in these regions. As LMICs are undergoing a rapid epidemiological transition, with a shifting burden from infectious diseases to non-communicable diseases, cancer care for all ages has become a global focus. To improve outcomes for children and adolescents diagnosed with cancer worldwide, an accurate appraisal of the global burden of childhood cancer is a necessary first step. In this Review, we analyse four studies of the global cancer burden that included data for children and adolescents. Each study used various overlapping and non-overlapping statistical approaches and outcome metrics. Moreover, to provide guidance on improving future estimates of the childhood global cancer burden, we propose several recommendations to strengthen data collection and standardise analyses. Ultimately, these data could help stakeholders to develop plans for national and institutional cancer programmes, with the overall aim of helping to reduce the global burden of cancer in children and adolescents.
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Affiliation(s)
- Nickhill Bhakta
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA; Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN, USA; Department of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA.
| | - Lisa M Force
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Claudia Allemani
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Rifat Atun
- Harvard T H Chan School of Public Health and Harvard Medical School, Harvard University, Boston, MA, USA
| | - Freddie Bray
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Michel P Coleman
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Eva Steliarova-Foucher
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - A Lindsay Frazier
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA
| | - Leslie L Robison
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Carlos Rodriguez-Galindo
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA; Department of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Christina Fitzmaurice
- Division of Hematology, Department of Medicine, University of Washington, Seattle, WA, USA; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
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Gibson TN, Beeput S, Gaspard J, George C, Gibson D, Jackson N, Leandre-Broome V, Palmer-Mitchell N, Alexis C, Bird-Compton J, Bodkyn C, Boyle R, McLean-Salmon S, Reece-Mills M, Quee-Brown CS, Allen U, Weitzman S, Blanchette V, Gupta S. Baseline characteristics and outcomes of children with cancer in the English-speaking Caribbean: A multinational retrospective cohort. Pediatr Blood Cancer 2018; 65:e27298. [PMID: 30094928 DOI: 10.1002/pbc.27298] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 05/24/2018] [Accepted: 05/30/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND English-speaking Caribbean (ESC) childhood cancer outcomes are unknown. PROCEDURE Through the SickKids-Caribbean Initiative (SCI), we established a multicenter childhood cancer database across seven centers in six ESC countries. Data managers entered patient demographics, disease, treatment, and outcome data. Data collection commenced in 2013, with retrospective collection to 2011 and subsequent prospective collection. RESULTS A total of 367 children were diagnosed between 2011 and 2015 with a median age of 5.7 years (interquartile range 2.9-10.6 years). One hundred thirty (35.4%) patients were diagnosed with leukemia, 30 (8.2%) with lymphoma, and 149 (40.6%) with solid tumors. A relative paucity of children with brain tumors was seen (N = 58, 15.8%). Two-year event-free survival (EFS) for the cohort was 48.5% ± 3.2%; 2-year overall survival (OS) was 55.1% ± 3.1%. Children with acute lymphoblastic leukemia (ALL) and Wilms tumor (WT) experienced better 2-year EFS (62.1% ± 6.4% and 66.7% ± 10.1%), while dismal outcomes were seen in children with acute myeloid leukemia (AML; 22.7 ± 9.6%), rhabdomyosarcoma (21.0% ± 17.0%), and medulloblastoma (21.4% ± 17.8%). Of 108 deaths with known cause, 58 (53.7%) were attributed to disease and 50 (46.3%) to treatment complications. Death within 60 days of diagnosis was relatively common in acute leukemia [13/98 (13.3%) ALL, 8/26 (30.8%) AML]. Despite this, traditional prognosticators adversely impacted outcome in ALL, including higher age, higher white blood cell count, and T-cell lineage. CONCLUSIONS ESC childhood cancer outcomes are significantly inferior to high-income country outcomes. Based on these data, interventions for improving supportive care and modifying treatment protocols are under way. Continued data collection will allow evaluation of interventions and ensure maximal outcome improvements.
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Affiliation(s)
- T N Gibson
- The University Hospital of the West Indies, Kingston, Jamaica
| | - S Beeput
- Bustamante Hospital for Children, Kingston, Jamaica
| | - J Gaspard
- Victoria Hospital, Castries, St. Lucia
| | - C George
- Eric Williams Medical Sciences Complex, Mount Hope, Trinidad and Tobago
| | - D Gibson
- Princess Margaret Hospital, Nassau, Bahamas
| | - N Jackson
- Milton Cato Memorial Hospital, Kingstown, St. Vincent and the Grenadines
| | | | | | - C Alexis
- Queen Elizabeth Hospital, Bridgetown, Barbados
| | | | - C Bodkyn
- Eric Williams Medical Sciences Complex, Mount Hope, Trinidad and Tobago
| | - R Boyle
- Milton Cato Memorial Hospital, Kingstown, St. Vincent and the Grenadines
| | | | - M Reece-Mills
- The University Hospital of the West Indies, Kingston, Jamaica
| | | | - U Allen
- The Hospital for Sick Children, Toronto, Canada
| | - S Weitzman
- The Hospital for Sick Children, Toronto, Canada
| | | | - S Gupta
- The Hospital for Sick Children, Toronto, Canada
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Joko-Fru WY, Parkin DM, Borok M, Chokunonga E, Korir A, Nambooze S, Wabinga H, Liu B, Stefan C. Survival from childhood cancers in Eastern Africa: A population-based registry study. Int J Cancer 2018; 143:2409-2415. [PMID: 29981149 DOI: 10.1002/ijc.31723] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 05/15/2018] [Accepted: 05/22/2018] [Indexed: 11/05/2022]
Abstract
Cancers occurring in children in Africa are often underdiagnosed, or at best diagnosed late. As a result, survival is poor, even for cancers considered 'curable'. With limited population-level data, understanding the actual burden and survival from childhood cancers in Africa is difficult. In this study, we aimed at providing survival estimates for the most common types of cancers affecting children aged 0-14 years, in three population-based Eastern African registries; Harare, Zimbabwe (Kaposi sarcoma, Wilms tumour (WT), non-Hodgkin lymphoma (NHL), retinoblastoma, and acute lymphocytic leukaemia (ALL)), Kampala, Uganda (Burkitt lymphoma, Kaposi sarcoma, WT, and retinoblastoma), and Nairobi, Kenya (ALL, retinoblastoma, WT, Burkitt lymphoma, and Hodgkin lymphoma). We included cases diagnosed within the years 1998-2009 and followed up till the end of 2011. We estimated the observed and relative survival at 1, 3, and 5 years after diagnosis. We studied 627 individual patient records. Median follow-up ranged from 2.2 months for children with Kaposi sarcoma in Harare to 30.2 months for children with ALL in Nairobi. The proportion of children lost to follow-up was highest in the first year after diagnosis. In Harare and Kampala, the 5-year relative survival was <46% for all cancer types. The 5-year relative survival was best for children in Nairobi, though with wider confidence intervals. Survival from childhood cancers in Africa is still poor, even for cancers with good prognosis and potential for cure. Supporting cancer detection, treatment, and registration activities could help improve survival chances for children with cancers in Africa.
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Affiliation(s)
- W Yvonne Joko-Fru
- The African Cancer Registry Network, INCTR African Registry Programme, Nuffield Department of Population Health, University of Oxford, Oxford, OX2 7HT, United Kingdom
| | - D Maxwell Parkin
- The African Cancer Registry Network, INCTR African Registry Programme, Nuffield Department of Population Health, University of Oxford, Oxford, OX2 7HT, United Kingdom
| | - Margaret Borok
- Zimbabwe National Cancer Registry, P.O. Box A449, Avondale, Harare, Zimbabwe
| | - Eric Chokunonga
- Zimbabwe National Cancer Registry, P.O. Box A449, Avondale, Harare, Zimbabwe
| | - Anne Korir
- Nairobi Cancer Registry, Kenya Medical Research Institute, Nairobi, Kenya
| | - Sarah Nambooze
- Kampala cancer Registry, Kampala Cancer Registry, Department of Pathology - College of Health Sciences, Makerere University, Kampala, Uganda
| | - Henry Wabinga
- Kampala cancer Registry, Kampala Cancer Registry, Department of Pathology - College of Health Sciences, Makerere University, Kampala, Uganda
| | - Biying Liu
- The African Cancer Registry Network, INCTR African Registry Programme, Nuffield Department of Population Health, University of Oxford, Oxford, OX2 7HT, United Kingdom
| | - Cristina Stefan
- AORTIC, 37A Main Road, Mowbray, Cape Town, 7705, South Africa
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Mazzucco W, Cusimano R, Mazzola S, Rudisi G, Zarcone M, Marotta C, Graziano G, D'Angelo P, Vitale F. Childhood and Adolescence Cancers in the Palermo Province (Southern Italy): Ten Years (2003⁻2012) of Epidemiological Surveillance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1344. [PMID: 29949937 PMCID: PMC6069060 DOI: 10.3390/ijerph15071344] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 06/16/2018] [Accepted: 06/23/2018] [Indexed: 02/06/2023]
Abstract
Italy has one of the highest paediatric cancer incidence rates in Europe. We compared cancer incidence and survival rates in children (0⁻14 years) and adolescents (15⁻19 years) residing in Palermo Province (PP) with statistics derived from Italian and European surveillance systems. We included all incident cancer cases, malignant tumours and non-malignant neoplasm of central nervous system (benign and uncertain whether malignant or benign), detected in children and adolescents by the Palermo Province Cancer Registry (PPCR) between 2003 and 2012. A jointpoint regression model was applied. Annual Average Percentage Changes were calculated. The Besag⁻York-Mollie model was used to detect any cluster. The 5-year survival analysis was computed using Kaplan-Meier and actuarial methods. We identified 555 paediatric cancer incident cases (90% “malignant tumours”). No difference in incidence rates was highlighted between PPCR and Italy 26 registries and between PPCR and Southern Europe. No jointpoint or significant trend was identified and no cluster was detected. The 5-year overall survival didn’t differ between PP and the Italian AIRTUM pool. A borderline higher statistically significant survival was observed in age-group 1⁻4 when comparing PPCR to EUROCARE-5. The epidemiological surveillance documented in the PP was a paediatric cancer burden in line with Italy and southern Europe. The study supports the supplementary role of general population-based cancer registries to provide paediatric cancer surveillance of local communities.
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Affiliation(s)
- Walter Mazzucco
- Department of Science for Health Promotion and Mother to Child Care "G. D'Alessandro", University of Palermo, via del Vespro, 133 Palermo, Italy.
- Clinical Epidemiology and Cancer Registry Unit, "P. Giaccone" University Hospital, via del Vespro, 133 Palermo, Italy.
| | | | - Sergio Mazzola
- Clinical Epidemiology and Cancer Registry Unit, "P. Giaccone" University Hospital, via del Vespro, 133 Palermo, Italy.
| | - Giuseppa Rudisi
- Local Health Unit 6, via Giacomo Cusmano, 24 Palermo, Italy.
| | - Maurizio Zarcone
- Clinical Epidemiology and Cancer Registry Unit, "P. Giaccone" University Hospital, via del Vespro, 133 Palermo, Italy.
| | - Claudia Marotta
- Department of Science for Health Promotion and Mother to Child Care "G. D'Alessandro", University of Palermo, via del Vespro, 133 Palermo, Italy.
| | - Giorgio Graziano
- Department of Science for Health Promotion and Mother to Child Care "G. D'Alessandro", University of Palermo, via del Vespro, 133 Palermo, Italy.
| | - Paolo D'Angelo
- Paediatric Haematology and Oncology Unit, ARNAS "Civico-Di Cristina-Benfratelli", Piazza Nicola Leotta, 4 Palermo, Italy.
| | - Francesco Vitale
- Department of Science for Health Promotion and Mother to Child Care "G. D'Alessandro", University of Palermo, via del Vespro, 133 Palermo, Italy.
- Clinical Epidemiology and Cancer Registry Unit, "P. Giaccone" University Hospital, via del Vespro, 133 Palermo, Italy.
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Ballantine KR, Hanna S, Macfarlane S, Bradbeer P, Teague L, Hunter S, Cross S, Skeen J. Childhood cancer registration in New Zealand: A registry collaboration to assess and improve data quality. Cancer Epidemiol 2018; 55:104-109. [PMID: 29902672 DOI: 10.1016/j.canep.2018.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 06/01/2018] [Accepted: 06/03/2018] [Indexed: 11/29/2022]
Abstract
AIM To evaluate the completeness and accuracy of child cancer registration in New Zealand. METHODS Registrations for children aged 0-14 diagnosed between 1/1/2010 and 31/12/2014 were obtained from the New Zealand Cancer Registry (NZCR) and the New Zealand Children's Cancer Registry (NZCCR). Six key data fields were matched using National Health Index numbers in order to identify and resolve registration discrepancies. Capture-recapture methods were used to assess the completeness of cancer registration. RESULTS 794 unique cases were reported; 718 from the NZCR, 721 from the NZCCR and 643 from both registries. 27 invalid cancer registrations were identified, including 19 residents of the Pacific Islands who had travelled to New Zealand for treatment. The NZCCR provided 55 non-malignant central nervous system tumour and 16 Langerhans cell histiocytosis cases which were not registered by the NZCR. The NZCR alerted the NZCCR to 18 cases missed due to human error and 23 cases that had not been referred to the specialist paediatric oncology centres. 762 cases were verified as true incident cases, an incidence rate of 166.8 per million. Registration accuracy for six key data fields was 98.6%. According to their respective inclusion criteria case completeness was 99.3% for the NZCR and 94.4% for the NZCCR. For childhood malignancies covered by both registries, capture-recapture methods estimated case ascertainment at greater than 99.9%. CONCLUSION With two national registries covering childhood cancers, New Zealand is uniquely positioned to undertake regular cooperative activities to ensure high quality data is available for research and patient care.
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Affiliation(s)
- Kirsten R Ballantine
- Children's Haematology/Oncology Centre, Christchurch Hospital, Christchurch, New Zealand; National Child Cancer Network, Auckland, New Zealand.
| | - Susan Hanna
- New Zealand Cancer Registry, Ministry of Health, Wellington, New Zealand
| | - Scott Macfarlane
- National Child Cancer Network, Auckland, New Zealand; Starship Blood and Cancer Centre, Starship Children's Hospital, Auckland, New Zealand
| | - Peter Bradbeer
- Starship Blood and Cancer Centre, Starship Children's Hospital, Auckland, New Zealand; Department of Pathology and Laboratory Medicine, Auckland City Hospital, Auckland, New Zealand
| | - Lochie Teague
- Starship Blood and Cancer Centre, Starship Children's Hospital, Auckland, New Zealand
| | - Sarah Hunter
- Starship Blood and Cancer Centre, Starship Children's Hospital, Auckland, New Zealand
| | - Siobhan Cross
- Children's Haematology/Oncology Centre, Christchurch Hospital, Christchurch, New Zealand
| | - Jane Skeen
- Starship Blood and Cancer Centre, Starship Children's Hospital, Auckland, New Zealand
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48
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Panagopoulou P, Georgakis MK, Baka M, Moschovi M, Papadakis V, Polychronopoulou S, Kourti M, Hatzipantelis E, Stiakaki E, Dana H, Tragiannidis A, Bouka E, Antunes L, Bastos J, Coza D, Demetriou A, Agius D, Eser S, Gheorghiu R, Šekerija M, Trojanowski M, Žagar T, Zborovskaya A, Ryzhov A, Dessypris N, Morgenstern D, Petridou ET. Persisting inequalities in survival patterns of childhood neuroblastoma in Southern and Eastern Europe and the effect of socio-economic development compared with those of the US. Eur J Cancer 2018; 96:44-53. [PMID: 29673989 DOI: 10.1016/j.ejca.2018.03.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 03/07/2018] [Accepted: 03/08/2018] [Indexed: 01/13/2023]
Abstract
AIM Neuroblastoma outcomes vary with disease characteristics, healthcare delivery and socio-economic indicators. We assessed survival patterns and prognostic factors for patients with neuroblastoma in 11 Southern and Eastern European (SEE) countries versus those in the US, including-for the first time-the Nationwide Registry for Childhood Hematological Malignancies and Solid Tumours (NARECHEM-ST)/Greece. METHODS Overall survival (OS) was calculated in 13 collaborating SEE childhood cancer registries (1829 cases, ∼1990-2016) and Surveillance, Epidemiology, and End Results (SEER), US (3072 cases, 1990-2012); Kaplan-Meier curves were used along with multivariable Cox regression models assessing the effect of age, gender, primary tumour site, histology, Human Development Index (HDI) and place of residence (urban/rural) on survival. RESULTS The 5-year OS rates varied widely among the SEE countries (Ukraine: 45%, Poland: 81%) with the overall SEE rate (59%) being significantly lower than in SEER (77%; p < 0.001). In the common registration period within SEE (2000-2008), no temporal trend was noted as opposed to a significant increase in SEER. Age >12 months (hazard ratio [HR]: 2.8-4.7 in subsequent age groups), male gender (HR: 1.1), residence in rural areas (HR: 1.3), living in high (HR: 2.2) or medium (HR: 2.4) HDI countries and specific primary tumour location were associated with worse outcome; conversely, ganglioneuroblastoma subtype (HR: 0.28) was associated with higher survival rate. CONCLUSIONS Allowing for the disease profile, children with neuroblastoma in SEE, especially those in rural areas and lower HDI countries, fare worse than patients in the US, mainly during the early years after diagnosis; this may be attributed to presumably modifiable socio-economic and healthcare system performance differentials warranting further research.
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Affiliation(s)
- Paraskevi Panagopoulou
- Department of Hygiene, Epidemiology and Medical Statistics Medical School, National and Kapodistrian University of Athens, Athens Greece
| | - Marios K Georgakis
- Department of Hygiene, Epidemiology and Medical Statistics Medical School, National and Kapodistrian University of Athens, Athens Greece
| | - Margarita Baka
- Department of Pediatric Hematology-Oncology, "Pan. & Agl. Kyriakou" Children's Hospital, Athens, Greece
| | - Maria Moschovi
- Pediatric Hematology/Oncology Unit, First Department of Pediatrics, University of Athens, "Agia Sofia" Children's Hospital, Athens, Greece
| | - Vassilios Papadakis
- Department of Pediatric Hematology-Oncology, "Agia Sofia" Children's Hospital, Athens, Greece
| | - Sophia Polychronopoulou
- Department of Pediatric Hematology-Oncology, "Agia Sofia" Children's Hospital, Athens, Greece
| | - Maria Kourti
- Department of Pediatric Hematology and Oncology, Hippokration Hospital, Thessaloniki, Greece
| | - Emmanuel Hatzipantelis
- Hematology-Oncology Unit, 2nd Pediatric Department, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Eftichia Stiakaki
- Department of Pediatric Hematology-Oncology, University of Crete, Heraklion, Greece
| | - Helen Dana
- Pediatric Hematology-Oncology Department, "Mitera" Children's Hospital, Athens, Greece
| | - Athanasios Tragiannidis
- Department of Hygiene, Epidemiology and Medical Statistics Medical School, National and Kapodistrian University of Athens, Athens Greece
| | - Evdoxia Bouka
- Department of Hygiene, Epidemiology and Medical Statistics Medical School, National and Kapodistrian University of Athens, Athens Greece
| | - Luis Antunes
- North Region Cancer Registry of Portugal (RORENO), Portuguese Institute of Oncology, Porto, Portugal
| | - Joana Bastos
- Registo Oncológico Regional do Centro (ROR-Centro), Portuguese Institute of Oncology, Coimbra, Portugal
| | - Daniela Coza
- The Oncology Institute "Prof. Dr. Ion Chiricuţă", Cluj-Napoca, Romania
| | - Anna Demetriou
- Health Monitoring Unit, Ministry of Health, Nicosia, Cyprus
| | - Domenic Agius
- Malta National Cancer Registry, Department for Policy in Health - Health Information and Research, Pieta, Malta
| | - Sultan Eser
- Izmir Cancer Registry, Izmir Hub, Izmir and Hacettepe, University Institute of Public Health, Ankara, Turkey
| | - Raluca Gheorghiu
- Regional Cancer Registry, National Institute of Public Health, Iasi, Romania
| | - Mario Šekerija
- Croatian Institute of Public Health, Croatian National Cancer Registry, Zagreb, Croatia; Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, Croatia
| | - Maciej Trojanowski
- Greater Poland Cancer Registry, Greater Poland Cancer Center, Poznań, Poland
| | - Tina Žagar
- Cancer Registry of Slovenia, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Anna Zborovskaya
- Belarusian Research Center for Paediatric Oncology, Haematology and Immunology, Childhood Cancer Subregistry of Belarus, Minsk, Belarus
| | - Anton Ryzhov
- National Cancer Registry of Ukraine, National Institute of Cancer, Kiev, Ukraine
| | - Nick Dessypris
- Department of Hygiene, Epidemiology and Medical Statistics Medical School, National and Kapodistrian University of Athens, Athens Greece
| | - Daniel Morgenstern
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, M5G 1X8, Canada
| | - Eleni Th Petridou
- Department of Hygiene, Epidemiology and Medical Statistics Medical School, National and Kapodistrian University of Athens, Athens Greece; Clinical Epidemiology Unit, Department of Medicine, Karolinska Institute, Stockholm, Sweden.
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49
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Aitken JF, Youlden DR, Moore AS, Baade PD, Ward LJ, Thursfield VJ, Valery PC, Green AC, Gupta S, Frazier AL. Assessing the feasibility and validity of the Toronto Childhood Cancer Stage Guidelines: a population-based registry study. THE LANCET CHILD & ADOLESCENT HEALTH 2018; 2:173-179. [DOI: 10.1016/s2352-4642(18)30023-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 12/11/2017] [Accepted: 12/11/2017] [Indexed: 12/18/2022]
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50
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Bhakta N, Rodriguez-Galindo C. The Toronto Guidelines: a practical means for childhood cancer staging. THE LANCET CHILD & ADOLESCENT HEALTH 2018; 2:158-159. [PMID: 30169247 DOI: 10.1016/s2352-4642(18)30024-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 01/11/2018] [Indexed: 01/04/2023]
Affiliation(s)
- Nickhill Bhakta
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN 38105, USA; Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN 38105, USA.
| | - Carlos Rodriguez-Galindo
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN 38105, USA
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