As reported in The Lancet Oncology by Botta et al, the population-based EUROCARE-6 study has shown an improvement in 5-year survival rates and estimated cure fractions across patients with childhood cancers diagnosed between 2010 and 2013 vs previous years. Findings differed among cancer types and across European regions.
As noted by the investigators, “The EUROCARE-5 study [conducted from 1999 to 2007] revealed disparities in childhood cancer survival among European countries, giving rise to important initiatives across Europe to reduce the gap.”
Study Details
The EUROCARE-6 study involved data on 135,847 children aged 0 to 14 years diagnosed from 2000 to 2013 and followed to the end of 2014. Patients were recruited from 80 population-based cancer registries in 31 European countries.
Key Findings
Five-year survival for all childhood cancer combined in Europe significantly improved (P < .05) from 78% (95% confidence interval [CI] = 78%–79%) for 2004 to 2006 to 81% (95% CI = 81%–82%) for 2010 to 2014. Significant improvements (all P < .05) were observed for acute myeloid leukemia (greatest increase; from 61% to 70%), central nervous system tumors, neuroblastoma, lymphoid leukemia, nephroblastoma, Hodgkin lymphoma, and retinoblastoma; survival remained stable for osteosarcoma, Ewing sarcoma, Burkitt lymphoma, non-Hodgkin lymphoma, and rhabdomyosarcoma.
For all cancers combined, inequalities persisted among European countries, with age-adjusted 5-year survival for 2010 to 2014 ranging from 71% (95% CI = 60%–79%; in Estonia) to 87% (95% CI = 77–93%; in Cyprus).
The projected 15-year survival for all patients with childhood cancer diagnosed from 2010 to 2013 was 78%, an increase from the 15-year survival of 72% among those diagnosed from 1998 to 2001. The estimated cure fraction when accounting for constant long-term risk for all cancers combined increased from 74% in 1998 to 2001 to 80% in 2010 to 2013. For those diagnosed in 2010 to 2013, estimated cure fractions ranged from 60% for central nervous system tumors to 99% for retinoblastoma, with intermediate values of 70% for acute myeloid leukemia and 90% for lymphoid leukemia. It was estimated that the yearly long-term mortality rate due to causes other than the diagnosed cancer was approximately 2 per 1,000 patients for all childhood cancers combined, with an approach to 0 per 1,000 for retinoblastoma.
The investigators concluded, “Childhood cancer survival is increasing over time in Europe but there are still some differences among countries. Regular monitoring of childhood cancer survival and estimation of the cure fraction through population-based registry data are crucial for evaluating advances in pediatric cancer care.”
Laura Botta, MSc, of the Evaluative Epidemiology Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, is the corresponding author for The Lancet Oncology article.
Disclosure: The study was funded by the European Commission. For full disclosures of the study authors, visit thelancet.com.
