Global inequalities for childhood leukemia affected five-year survival rates.
Leukemia, the most common cancer in children, has shown improved survival rates in the last few years. However, the good news is better in some countries than others.
A new study from the London School of Hygiene and Tropical Medicine found significant global inequalities in survival rates among children with leukemia.
Lead author Audrey Bonaventure, MD, said in a press release, “These findings show the extent of worldwide inequalities in access to optimal health care for children with cancer. Survival for children with ALL can be as high as 90% at five years after diagnosis, and up to 80% for children with AML, but in some countries, survival remains below 60% for both diseases. Providing additional resources, alongside evidence-based initiatives such as international collaborations and treatment guidelines, could improve access to efficient treatment and care for all children with leukemia.”
Dr. Bonaventure is an assistant clinical professor at the London School of Hygiene & Tropical Medicine in the United Kingdom.
Dr. Bonaventure and colleagues analyzed data on almost 90,000 children from 198 cancer registries in 53 countries. Using the data provided, the researchers estimated survival rates for acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) – the two most common types of leukemia – as well as other blood cancers in children.
Overall, five-year survival rates for ALL and AML increased in most countries between 1995 and 2009.
Survival for ALL was highest of the two types of cancer, ranging from 11 percent in China to 92 percent in Germany (although for different years). Five-year survival for AML was lowest in China at four percent between 1995 and 1999. Sweden had the highest survival rate in that time frame at 78 percent.
Between 2005 and 2009, survival rates ranged from 33 percent in Bulgaria to 78 percent in Germany. Some countries, such as Germany and Austria, consistently show higher survival rates, which may be due to following treatment protocols more closely.
In the US, the survival rate for ALL rose from 83 percent in 1995-1999 to 88 percent in 2005-2009.
The age of the child at diagnosis has a significant effect on survival – younger children have lower survival rates and infants have very low survival rates.
In a comment linked to the study, Professor Philippe Autier, from the University of Strathclyde Institute of Global Public Health at the International Prevention Research Institute, France, commented, “… the accomplishment of 5-year net survival of around 80% in many high-income countries should not distract from the dire reality that about 80% of leukemia cases in children occur in low-income and middle-income countries where there is little access to the sophisticated and costly specialised medical resources required for the optimum management of these conditions. From a worldwide perspective, it is the adoption by low- and middle-income countries of affordable, locally adapted, multidisciplinary management programmes that is likely to translate into the largest gains in survival for children with hematological cancer.”
The study was published in the April issue of The Lancet Haematology.
Funding for the study was provided by multiple sources, including the Canadian Partnership Against Cancer, Cancer Focus Northern Ireland, Cancer Institute New South Wales, Cancer Research UK, US Centers for Disease Control and Prevention, Swiss Re, Swiss Cancer Research Foundation, Swiss Cancer League and the University of Kentucky.
None of the authors reported a conflict of interest.
The Lancet Haematology, “Worldwide comparison of survival from childhood leukemia for 1995–2009, by subtype, age, and sex (CONCORD-2): a population-based study of individual data for 89,828 children from 198 registries in 53 countries”
Written by: Beth Greenwood, RN | Medically reviewed by: Dr. Robert Carlson, M.D.