Groundbreaking Study Reveals Impact of Cancer Spread at Diagnosis on Childhood Survival Rates

A major collaborative study, spearheaded by researchers from UCL and Fondazione IRCCS Istituto Nazionale dei Tumori (INT) in Milan, has for the first time meticulously detailed how far children's cancer has spread at diagnosis. This innovative approach allows for crucial international comparisons, shedding new light on survival disparities.

The study indicates that differences in tumor stage at diagnosis may explain variations in childhood cancer survival rates between certain European regions and specific tumor types.

Methodology and Key Findings

Published in JAMA Network Open, the extensive research analyzed high-quality data from 9,883 children. This robust dataset was drawn from 73 population-based cancer registries across 27 countries, predominantly in Europe. The study zeroed in on six specific childhood cancers: neuroblastoma, Wilms tumor, medulloblastoma, osteosarcoma, Ewing sarcoma, and rhabdomyosarcoma, all diagnosed between 2014 and 2017.

The findings revealed a strong link between three-year survival and tumor stage at diagnosis across all six cancers, with survival rates consistently decreasing as the cancer stage advanced. This critical correlation underscores the importance of early detection. The International Benchmarking of Childhood Cancer Survival by Stage (BENCHISTA) project, jointly led by UCL and INT, significantly enhanced the consistency and completeness of childhood cancer data collection by national cancer registries, utilizing the established Toronto Childhood Cancer Stage Guidelines.

Regional Disparities Emerge

Using Central Europe (comprising Austria, Belgium, France, Germany, Switzerland, and the Netherlands) as a vital benchmark, the study identified significant variations in overall three-year survival rates among some regions for four of the six cancers examined.

Neuroblastoma: Earlier Diagnosis Crucial

Children diagnosed with neuroblastoma in the UK and Ireland exhibited notably lower survival rates compared to their counterparts in Central Europe. This concerning difference was directly attributed to the relatively later stage at which this aggressive cancer was diagnosed in the UK and Ireland.

Ewing Sarcoma: Beyond Diagnosis Stage

In a contrasting finding, lower survival rates for Ewing Sarcoma in Eastern Europe and the UK and Ireland, when compared to Central Europe, were not solely explained by later diagnosis. This disparity was observed only in patients whose tumors had already spread, suggesting other complex factors, such as the specific location of spread or differing treatment approaches, warrant further investigation.

Implications and Future Outlook

These compelling findings highlight the critical need for both earlier diagnosis and accurate assessment of cancer spread to significantly improve survival for many children. However, the study also indicates that early diagnosis alone may not resolve all existing disparities. Other contributing factors, such as differences in treatment protocols, varying access to specialized care, and broader health system variations, are likely at play.

The next phase of the BENCHISTA project is poised to delve deeper into these additional factors. It will also report five-year survival rates, which serve as the standard epidemiological measure for cancer outcomes.

The project aims to provide crucial evidence to guide health policies and ultimately improve diagnosis and care for children with cancer globally.