ArticlesChildhood cancer survival in Europe 1999–2007: results of EUROCARE-5—a population-based study
Introduction
The EUROCARE project produces population-based cancer survival and related information that depicts the situation in Europe as accurately as possible. It encourages the participation of all European cancer registries that have good-quality survival data.
Survival after childhood cancers is now generally good and better than for adults. Previous EUROCARE studies estimated that during 1995–2002, 5-year all-cancer survival was 56% for adults,1 and 81% for children.2 However, large differences exist between countries: ranging from 48% to 62% for adults, and 75% to 86% for children.1, 2 Survival improved between the late 1990s and the early 2000s, particularly for acute lymphoid leukaemia and CNS cancers.2
EUROCARE-5 assessed the largest European population yet, with a much greater participation of cancer registries from eastern Europe. Here, we present EUROCARE-5 survival data for children diagnosed with cancer between 2000 and 2007, assess whether survival differences between European countries have changed, and investigate whether survival for the main childhood cancers has changed from previous periods.
Section snippets
Study design and data collection
The EUROCARE-5 database contains data for 157 499 cancers diagnosed in European children (age 0–14 years; 14 years is usually the cutoff used in studies of childhood cancer) from Jan 1, 1978, to Dec 31, 2007, with data for whether the patient is alive or date of death updated to Dec 31, 2008. The data were provided by 74 population-based cancer registries in 29 countries: Denmark, Finland, Iceland, Norway, and Sweden (grouped as northern Europe); Bulgaria, Estonia, Hungary, Latvia, Lithuania,
Results
We extracted and analysed two datasets from the EUROCARE-5 database. The first included data for 60 415 children diagnosed with cancer between 2000 and 2007 for which all 74 cancer registries had data. Table 1 shows the main characteristics by country of this dataset, with principal data quality indicators. After checking and correcting,10 836 cases were excluded (table 1). Thus, we included 59 579 cases in the analysis. Of these, 56 305 (94·5%) were microscopically verified. For most countries
Discussion
5-year survival for all cancers combined is increasing in Europe—as reported in previous EUROCARE studies2, 12—with HR falling on average by 3% per year. The most notable improvements were in eastern Europe, where 5-year survival rose from 65% in 1999–2001 to 70% in 2005–07.
Despite these improvements, there are still survival disparities between countries and European regions, but with few exceptions, survival was lowest in eastern Europe. Many factors could explain the poor survival in eastern
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