SummaryBackgroundGlobal inequalities in access to health care are reflected in differences in cancer survival. The CONCORD programme was designed to assess worldwide differences and trends in population-based cancer survival. In this population-based study, we aimed to estimate survival inequalities globally for several subtypes of childhood leukaemia.MethodsCancer registries participating in CONCORD were asked to submit tumour registrations for all children aged 0–14 years who were diagnosed with leukaemia between Jan 1, 1995, and Dec 31, 2009, and followed up until Dec 31, 2009. Haematological malignancies were defined by morphology codes in the International Classification of Diseases for Oncology, third revision. We excluded data from registries from which the data were judged to be less reliable, or included only lymphomas, and data from countries in which data for fewer than ten children were available for analysis. We also excluded records because of a missing date of birth, diagnosis, or last known vital status. We estimated 5-year net survival (ie, the probability of surviving at least 5 years after diagnosis, after controlling for deaths from other causes [background mortality]) for children by calendar period of diagnosis (1995–99, 2000–04, and 2005–09), sex, and age at diagnosis (<1, 1–4, 5–9, and 10–14 years, inclusive) using appropriate life tables. We estimated age-standardised net survival for international comparison of survival trends for precursor-cell acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML).FindingsWe analysed data from 89 828 children from 198 registries in 53 countries. During 1995–99, 5-year age-standardised net survival for all lymphoid leukaemias combined ranged from 10·6% (95% CI 3·1–18·2) in the Chinese registries to 86·8% (81·6–92·0) in Austria. International differences in 5-year survival for childhood leukaemia were still large as recently as 2005–09, when age-standardised survival for lymphoid leukaemias ranged from 52·4% (95% CI 42·8–61·9) in Cali, Colombia, to 91·6% (89·5–93·6) in the German registries, and for AML ranged from 33·3% (18·9–47·7) in Bulgaria to 78·2% (72·0–84·3) in German registries. Survival from precursor-cell ALL was very close to that of all lymphoid leukaemias combined, with similar variation. In most countries, survival from AML improved more than survival from ALL between 2000–04 and 2005–09. Survival for each type of leukaemia varied markedly with age: survival was highest for children aged 1–4 and 5–9 years, and lowest for infants (younger than 1 year). There was no systematic difference in survival between boys and girls.InterpretationGlobal inequalities in survival from childhood leukaemia have narrowed with time but remain very wide for both ALL and AML. These results provide useful information for health policy makers on the effectiveness of health-care systems and for cancer policy makers to reduce inequalities in childhood cancer survival.FundingCanadian Partnership Against Cancer, Cancer Focus Northern Ireland, Cancer In...
The distribution of ovarian cancer histology varies widely worldwide. Type I epithelial, germ cell and sex cord-stromal tumours are generally associated with higher survival than type II tumours, so the proportion of these tumours may influence survival estimates for all ovarian cancers combined. The distribution of histological groups should be considered when comparing survival between countries and regions.
Objective-To examine whether the observed excess of childhood leukaemia and non-Hodgkin's lymphoma in the area around the Dounreay nuclear installation is associated with established risk factors, or with factors related to the plant, or with parental occupation in the nuclear industry.Design-Case-control study. Results-No raised relative risks were found for prenatal exposure to x rays, social class of parents, employment at Dounreay before conception or diagnosis, father's dose of ionising radiation before conception, or child's residence within 50 m of the path of microwave transmission beams. Results also proved negative for all lifestyle factors except an apparent association with use of beaches within 25 km of Dounreay. However, this result was based on small numbers, arose in the context of multiple hypothesis testing, and is certainly vulnerable to possible systematic bias.Conclusion-The raised incidence of childhood leukaemia and non-Hodgkin's lymphoma around Dounreay cannot be explained by paternal occupation at Dounreay or by paternal exposure to external ionising radiation before conception. The observation of an apparent association between the use of beaches around Dounreay and the development of childhood leukaemia and non-Hodgkin's lymphoma might be an artefact ofmultiple testing and influenced by recall bias.
Objective-To study the source of non-outbreak legionnaires' disease, particularly the role of cooling towers, by comparing the locations of patients' homes in relation to the location of cooling towers.
S_nary Children (0-14 years) with malignant brain and central nervous system (CNS) tumours (ICD9 191 and 192) were listed from the Scottish Cancer Registration Scheme for the years 1975-90. These cases formed the basis for validation and verification procedures aimed at providing a complete and accurate data set for epidemiological analyses. A variety of data sources were cross-checked to optimise ascertainment, and resulting from this 5.7% of validated cases were found on the cancer registry with diagnostic codes outside the ICD-9 range [191][192]. A further 8.4% were newly registered cases. Analyses were conducted on the validated data set showing a significant temporal increase in incidence rates over the 16 year study period with an average annual percentage change of + 2.6%. Large-scale geographical heterogeneity was also found, with a particularly high incidence in the Fife and Lothian areas and a low incidence in Grampian. Examination of associations with socioeconomic status, using the Carstairs deprivation index, revealed a rising trend in incidence strongly linked to areas with increasing levels of affluence. Our results suggest that for studies of childhood CNS tumours validation of cancer registry data is necessary and large-scale geographical variation and socioeconomic factors should be taken into account in any investigation of distribution in small geographical areas.Recent technological advances in a range of diagnostic techniques have made the identification of tumours in the brain and central nervous system potentially more complete and accurate. However, temporal trends in the incidence of brain tumours are sparsely documented for children and young people, and international variation shows inconsistent trends (Davis et al., 1990, Mao et al., 1991. Suggested increases in incidence must be interpreted in relation to the impact of improved diagnostic techniques on the ascertainment of cases.As a preliminary to a geographical study investigating the incidence of childhood cancer near nuclear facilities in Scotland, a validation exercise was initiated to provide an optimal data set in terms of completeness and accuracy. This involved cross-checking of alternative sources of ascertainment, validation of diagnosis and verification of case details. As part of this exercise the incidence and pathology of central nervous system (CNS) tumours in children in Scotland between 1975 and have been reviewed.The main source of data for the study was the Scottish National Cancer Registration Scheme (SMR6). The two aims of this paper are to assess the completeness and accuracy of the original cancer registration data for childhood CNS tumours and, for the validated data set, to describe the incidence and broad geographical distribution in Scotland. For each cancer registration and potential new case a form was created showing initial diagnosis and case details and was passed to the collaborating pathologist (J.W.I.). The form was structured in order to permit the pathologists to indicate whether or not a par...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2025 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.