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International variation in childhood cancer mortality rates from 2001-2015: comparison of trends in the International Cancer Benchmarking Partnership countries

Smith, L; Stiller, CA; Aitken, JF; Hjalgrim, LL; Johannesen, T; Lahteenmaki, P; McCabe, MG; ... Feltbower, RG; + view all (2021) International variation in childhood cancer mortality rates from 2001-2015: comparison of trends in the International Cancer Benchmarking Partnership countries. International Journal of Cancer , 150 (1) pp. 28-37. 10.1002/ijc.33774. Green open access

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Abstract

Despite improved survival rates, cancer remains one of the most common causes of childhood death. The International Cancer Benchmarking Partnership (ICBP) showed variation in cancer survival for adults. We aimed to assess and compare trends over time in cancer mortality between children, adolescents and young adults (AYAs) and adults in the six countries involved in the ICBP: UK, Denmark, Australia, Canada, Norway and Sweden. Trends in mortality between 2001 and 2015 in the six original ICBP countries were examined. Age standardized mortality rates (ASR per million) were calculated for all cancers, leukaemia, malignant and benign CNS tumours, and non-CNS solid tumours. ASRs were reported for children (age 0-14 years), AYAs aged 15-39 years, and adults aged 40 years and above. Average annual percentage change (AAPC) in mortality rates per country were estimated using Joinpoint regression. For all cancers combined, significant temporal reductions were observed in all countries and all age groups. However, the overall AAPC was greater for children (-2.9; 95% CI -4.0 to -1.7) compared to AYAs (-1.8; -2.1 to -1.5) and adults aged>40 years (-1.5; -1.6 to -1.4). This pattern was mirrored for leukaemia, CNS tumours and non-CNS solid tumours, with the difference being most pronounced for leukaemia: AAPC for children -4.6 (-6.1 to -3.1) vs AYAs -3.2 (-4.2 to -2.1) and over 40s -1.1 (-1.3 to -0.8). AAPCs varied between countries in children for all cancers except leukaemia, and in adults over 40 for all cancers combined, but not in subgroups. Improvements in cancer mortality rates in ICBP countries have been most marked among children aged 0-14s in comparison to 15-39 and over 40 year olds. This may reflect better care, including centralised service provision, treatment protocols and higher trial recruitment rates in children compared to older patients. This article is protected by copyright. All rights reserved.

Type: Article
Title: International variation in childhood cancer mortality rates from 2001-2015: comparison of trends in the International Cancer Benchmarking Partnership countries
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/ijc.33774
Publisher version: https://doi.org/10.1002/ijc.33774
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions.
Keywords: Childhood cancer, epidemiology, mortality trends
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Biology and Cancer Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10135756
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