Childhood cancer survival in Europe and the United States
Childhood cancer survival in Europe and the United States
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DOI：
10.1002/cncr.10833
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发表时间：
2002-10-15
期刊：
影响因子：
6.2
通讯作者：
Berrino, F
中科院分区：
文献类型：
--
作者：
Gatta, G;Capocaccia, R;Berrino, F
背景。与欧洲相比，美国大多数主要成人癌症的存活率更高。本研究的目的是确定跨大西洋生存率的差异是否也存在于儿童癌症中。作者分析了1985-1989年间年龄< 15岁被诊断为恶性疾病的16148名欧洲患者和3476名美国患者。这些患者来自17个国家的34个EUROCARE癌症登记处和美国的9个SEER登记处。作者考虑了国际儿童癌症分类的14个主要诊断类别。为了增强比较的力量，他们还将所有儿童癌症一并考虑在内。采用精算方法计算观察生存率。对于所有癌症，北欧的5年生存率最高，为75%(95%可信区间[95% ci]， 72-78%)，东欧的5年生存率最低，为55% （95% ci, 52-58%）。美国的存活率与意大利和其他西欧国家的存活率大致相当，为70%。北欧淋巴性白血病患者的生存率也最高（83%;95%CI, 78-88%）；而德国、意大利和其他西欧国家的生存率与美国患者的平均生存率相似（77%;95%CI, 74-80%）。与美国相比，欧洲神经母细胞瘤和肾母细胞瘤患者的生存率低7-9%，视网膜母细胞瘤患者的生存率高8%（均具有显著性）。骨肉瘤、室管膜瘤和成神经管细胞瘤患者（在美国生存率较高）和急性非淋巴细胞白血病患者（在欧洲生存率较高）的差异较小，但不显著。其他肿瘤的存活率在两组人群中也非常相似。与成人癌症患者的生存率不同，欧洲（东欧除外）儿童癌症患者的生存率与美国非常相似。儿童癌症通常比成人癌症对治疗更有反应，但这些结果也可能反映了这些治疗对大多数患者的广泛可及性。这些结果与解释成人癌症存活率的差异有关。(C) 2002年美国癌症协会。
BACKGROUND. Survival rates for most major adult cancers are higher in the United States compared with the survival rates in Europe. The objective of this study was to determine whether transatlantic differences in survival also are present in childhood cancers.METHODS. The authors analyzed 16,148 European patients and 3476 patients in the United States who were diagnosed with malignant disease at age < 15 years during 1985-1989. The patients were obtained from 34 EUROCARE cancer registries in 17 countries and from 9 SEER registries in the United States. The authors considered the major 14 diagnostic categories of the International Classification of Childhood Cancers. To increase the power of comparisons, they also considered all childhood cancers together. Observed survival was calculated by actuarial methods.RESULTS. For all cancers combined, northern Europe had the highest 5-year survival rate at 75% (95% confidence interval [95%CI], 72-78%), and Eastern Europe had the lowest survival rate at 55% (95%CI, 52-58%). The survival rate in the United States was roughly comparable to the survival rates in Italy and other Western European countries at 70%. Northern Europe also had highest survival rate for patients with lymphoid leukemias (83%; 95%CI, 78-88%); whereas Germany, Italy, and the other Western European countries had survival rates similar to the average survival rate for patients in the United States (77%; 95%CI, 74-80%). The survival rate was 7-9% lower in Europe compared with the survival rate in United States for patients with neuroblastoma and Wilms tumors and 8% higher for patients with retinoblastoma (all significant). Small, nonsignificant differences were found for patients with osteosarcoma, ependymoma, and medulloblastorna (with a higher survival rate in the United States) and for patients with acute nonlymphocytic leukemia (with a higher survival rate in Europe). Very similar survival rates among the two populations were found for the other cancers.CONCLUSIONS. Unlike the survival of adults with cancer, the survival of children with cancer in Europe (except Eastern Europe) is very similar to that in the United States. Childhood cancers are generally more responsive to therapy than adult cancers, but these results also may reflect wide accessibility of these treatments for most patients. These results are relevant to the interpretation of differences in adult cancer survival. (C) 2002 American Cancer Society.