Abstract
Introduction
Tumours of the central nervous system are among the leading causes of cancer-related death in children. Population-based cancer survival reflects the overall effectiveness of a health care system in managing cancer. Inequity in access to care world-wide may result in survival disparities.
Methods
We considered children (0-14 years) diagnosed with a brain tumour during 2000-2014, regardless of tumour behaviour. Data underwent a rigorous, three-phase quality control as part of CONCORD-3. We implemented a revised version of the International Classification of Childhood Cancer (3
rd edition) to control for under-registration of non-malignant astrocytic tumours. We estimated net survival using the unbiased non-parametric Pohar Perme estimator.
Results
The study included 67,776 children. We estimated survival for 12 histology groups, each based on relevant ICD-O-3 codes. Age-standardised five-year net survival for low-grade astrocytoma ranged between 84% and 100% world-wide during 2000-2014. In most countries, five-year survival was 90% or more during 2000-2004, 2005-2009 and 2010-2014. Global variation in survival for medulloblastoma was much wider, with age-standardised five-year net survival between 47% and 86% for children diagnosed during 2010-2014.
Conclusions
To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumours in children, by histology. We devised an enhanced version of ICCC-3 to account for differences in cancer registration practices world-wide. Our findings may have public health implications, because low-grade glioma is one of the six index childhood cancers included by WHO in the Global Initiative for Childhood Cancer.
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