TY - JOUR
T1 - Significant improvement in survival of advanced stage childhood and young adolescent cancer in the Netherlands since the 1990s
AU - Schulpen, Maya
AU - Visser, Otto
AU - Reedijk, Ardine M J
AU - Kremer, Leontien C M
AU - Zwaan, Christian Michel
AU - Eggermont, Alexander M M
AU - Coebergh, Jan W
AU - Pieters, Rob
AU - Karim-Kos, Henrike E
N1 - Funding Information:
The authors would like to thank KiKa for funding this study and the registration team of the Netherlands Comprehensive Cancer Organisation (IKNL) for the collection of data for the Netherlands Cancer Registry. In addition, all paediatric oncology centres and oncologists in the Netherlands who have treated paediatric patients with cancer since the 1990s and have made their data available are thanked. The authors also thank Prof. Pieter Wesseling and Raoull Hoogendijk for sharing their knowledge concerning the diagnosis of CNS tumours in young patients.
Funding Information:
The present work was funded by Stichting Kinderen Kankervrij (KiKa) (project number 207). The funding source had no role in the study design, data collection, analyses and interpretation of the results or in the writing of this manuscript and the decision to submit the article for publication.
Publisher Copyright:
© 2021 The Authors
PY - 2021/11
Y1 - 2021/11
N2 - Background: This is the first national study on trends in cancer survival and mortality for children and young adolescents in the Netherlands including unique information on stage at diagnosis. Methods: All neoplasms in patients <18 years, diagnosed between 1990 and 2015 (N = 14,060), were derived from the Netherlands Cancer Registry. Cohort and period survival analyses were used to estimate observed survival (OS). Time trends in OS and mortality rates were evaluated by parametric survival models and average annual percentage change, respectively. Results: Between 1990 and 2015, 5-year OS and 10-year OS of childhood and young adolescent cancer have improved significantly by 9 percent points, reaching 81% and 78%, respectively. Favourable trends in survival were observed for all age groups and most diagnostic (sub)groups, being particularly pronounced for advanced disease. Non-Hodgkin lymphomas Ann Arbor stage III, metastatic neuroblastomas (age ≥18 months) and Ewing bone sarcomas showed significant improvements in 5-year OS. Compared with 1990–99, the risk of dying within five years of diagnosis was decreased significantly during 2000–09 (hazard ratio [HR] = 0.8) and 2010–15 (HR = 0.6), after adjustment for age, gender and follow-up time. Nonetheless, the prognosis of young patients suffering from central nervous system tumours, neuroblastoma and osteosarcomas remained modest, with 5-year OS <70% and 10-year OS <65%. Childhood and young adolescent cancer mortality decreased by an average of 2.0% annually between 1990 and 2018. Conclusions: Significant progress has been realised in the prognosis of childhood and young adolescent cancer in the Netherlands since the 1990s. Survival improvements were especially evident for patients with advanced stages and were also reflected in the declining mortality rates.
AB - Background: This is the first national study on trends in cancer survival and mortality for children and young adolescents in the Netherlands including unique information on stage at diagnosis. Methods: All neoplasms in patients <18 years, diagnosed between 1990 and 2015 (N = 14,060), were derived from the Netherlands Cancer Registry. Cohort and period survival analyses were used to estimate observed survival (OS). Time trends in OS and mortality rates were evaluated by parametric survival models and average annual percentage change, respectively. Results: Between 1990 and 2015, 5-year OS and 10-year OS of childhood and young adolescent cancer have improved significantly by 9 percent points, reaching 81% and 78%, respectively. Favourable trends in survival were observed for all age groups and most diagnostic (sub)groups, being particularly pronounced for advanced disease. Non-Hodgkin lymphomas Ann Arbor stage III, metastatic neuroblastomas (age ≥18 months) and Ewing bone sarcomas showed significant improvements in 5-year OS. Compared with 1990–99, the risk of dying within five years of diagnosis was decreased significantly during 2000–09 (hazard ratio [HR] = 0.8) and 2010–15 (HR = 0.6), after adjustment for age, gender and follow-up time. Nonetheless, the prognosis of young patients suffering from central nervous system tumours, neuroblastoma and osteosarcomas remained modest, with 5-year OS <70% and 10-year OS <65%. Childhood and young adolescent cancer mortality decreased by an average of 2.0% annually between 1990 and 2018. Conclusions: Significant progress has been realised in the prognosis of childhood and young adolescent cancer in the Netherlands since the 1990s. Survival improvements were especially evident for patients with advanced stages and were also reflected in the declining mortality rates.
KW - Cancer epidemiology
KW - Mortality
KW - Paediatric oncology
KW - Stage at diagnosis
KW - Survival
KW - Trends
UR - http://www.scopus.com/inward/record.url?scp=85114185048&partnerID=8YFLogxK
U2 - 10.1016/j.ejca.2021.08.001
DO - 10.1016/j.ejca.2021.08.001
M3 - Article
C2 - 34492587
SN - 0959-8049
VL - 157
SP - 81
EP - 93
JO - European Journal of Cancer
JF - European Journal of Cancer
ER -