Survival among children diagnosed with acute lymphoblastic leukemia in the United States, by race and age, 2001 to 2009: Findings from the CONCORD-2 study

BACKGROUND

Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy. This report describes the survival of children with ALL in the United States using the most comprehensive and up-to-date cancer registry data.

METHODS

Data from 37 state cancer registries that cover approximately 80% of the US population were used. Age-standardized survival up to 5 years was estimated for children aged 0-14 years who were diagnosed with ALL during 2 periods (2001-2003 and 2004-2009).

RESULTS

In total, 17,500 children with ALL were included. The pooled age-standardized net survival estimates for all US registries combined were 95% at 1 year, 90% at 3 years, and 86% at 5 years for children diagnosed during 2001-2003, and 96%, 91%, and 88%, respectively, for those diagnosed during 2004-2009. Black children who were diagnosed during 2001-2003 had lower 5-year survival (84%) than white children (87%) and had less improvement in survival by 2004-2009. For those diagnosed during 2004-2009, the 1-year and 5-year survival estimates were 96% and 89%, respectively, for white children and 96% and 84%, respectively, for black children. During 2004-2009, survival was highest among children aged 1 to 4 years (95%) and lowest among children aged <1 year (60%).

CONCLUSIONS

The current results indicate that overall net survival from childhood ALL in the United States is high, but disparities by race still exist, especially beyond the first year after diagnosis. Clinical and public health strategies are needed to improve health care access, clinical trial enrollment, treatment, and survivorship care for children with ALL. Cancer 2017;123:5178-89. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

Stomach cancer survival in the United States by race and stage (2001-2009): Findings from the CONCORD-2 study

BACKGROUND

Stomach cancer was a leading cause of cancer-related deaths early in the 20th century and has steadily declined over the last century in the United States. Although incidence and death rates are now low, stomach cancer remains an important cause of morbidity and mortality in black, Asian and Pacific Islander, and American Indian/Alaska Native populations.

METHODS

Data from the CONCORD-2 study were used to analyze stomach cancer survival among males and females aged 15 to 99 years who were diagnosed in 37 states covering 80% of the US population. Survival analyses were corrected for background mortality using state-specific and race-specific (white and black) life tables and age-standardized using the International Cancer Survival Standard weights. Net survival is presented up to 5 years after diagnosis by race (all, black, and white) for 2001 through 2003 and 2004 through 2009 to account for changes in collecting Surveillance, Epidemiology, and End Results Summary Stage 2000 data from 2004.

RESULTS

Almost one-third of stomach cancers were diagnosed at a distant stage among both whites and blacks. Age-standardized 5-year net survival increased between 2001 to 2003 and 2004 to 2009 (26.1% and 29%, respectively), and no differences were observed by race. The 1-year, 3-year, and 5-year survival estimates were 53.1%, 33.8%, and 29%, respectively. Survival improved in most states. Survival by stage was 64% (local), 28.2% (regional), and 5.3% (distant).

CONCLUSIONS

The current results indicate high fatality for stomach cancer, especially soon after diagnosis. Although improvements in stomach cancer survival were observed, survival remained relatively low for both blacks and whites. Primary prevention through the control of well-established risk factors would be expected to have the greatest impact on further reducing deaths from stomach cancer. Cancer 2017;123:4994-5013. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.