Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas.
Division of Pediatric Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota.
Cancer. 2022 Jul 15;128(14):2760-2767. doi: 10.1002/cncr.34248. Epub 2022 Apr 28.
BACKGROUND: The Childhood Cancer Research Network (CCRN) was established by the Children's Oncology Group (COG) as a resource for epidemiologic studies of childhood cancer. The objective of this study was to evaluate the representativeness of CCRN and identify factors associated with enrollment. METHOD: The number of US childhood patients with cancer diagnosed <20 years of age enrolled in CCRN (2008-2015) was compared to expected counts, calculated from Surveillance, Epidemiology, and End Results incidence rates and US Census population estimates. Observed-to-expected ratios and corresponding 95% confidence intervals (CI) were estimated across sex, race, diagnosis age, calendar year, and cancer diagnosis groups. Multivariable linear regression models were generated to evaluate the association between open COG phase 3 therapeutic trials and CCRN enrollment rates. RESULT: The 43,110 cases enrolled in CCRN represented 36% of the expected childhood cancers diagnosed from 2008 to 2015 (N = 120,118). CCRN enrollment ratios [95% CI] were highest among males (0.38 [95% CI, 0.37-0.38]), non-Hispanics (0.35 [95% CI, 0.35-0.36]), and those diagnosed from 1 to 4 years of age (0.50 [95% CI, 0.50-51]). Enrollment ratios varied by diagnosis group, with leukemia, myeloproliferative diseases, myelodysplastic diseases (0.55 [95% CI, 0.54-0.55]), and renal tumors (0.55 [95% CI, 0.53-0.58]) having the highest enrollment. After adjusting for year of diagnosis and cancer diagnosis, there was a 3.1% [95% CI, 0.6-5.6%] increase in CCRN enrollment during windows of open COG therapeutic trials. CONCLUSIONS: Despite enrolling only 36% of newly diagnosed cases, CCRN remains a valuable resource for investigators conducting childhood cancer etiology and survivorship research. The results of this study may inform efforts to improve enrollment on current and future COG nontherapeutic registry protocols.
背景:儿童肿瘤学组(COG)成立了儿童癌症研究网络(CCRN),作为儿童癌症的流行病学研究资源。本研究的目的是评估 CCRN 的代表性,并确定与入组相关的因素。
方法:将 2008 年至 2015 年期间在美国诊断为<20 岁的癌症患儿的 CCRN 入组人数(2008-2015 年)与根据监测、流行病学和最终结果(SEER)发病率和美国人口普查人口估计数计算的预期人数进行比较。在性别、种族、诊断年龄、日历年份和癌症诊断组之间,计算观察到的与预期的比值(O/E)及其 95%置信区间(CI)。采用多变量线性回归模型评估开放 COG 阶段 3 治疗性试验与 CCRN 入组率之间的关系。
结果:在 2008 年至 2015 年期间诊断的 120118 例儿童癌症中,CCRN 入组的 43110 例患者占预期病例的 36%(N=43110)。CCRN 入组率[95%CI]最高的是男性(0.38[95%CI,0.37-0.38])、非西班牙裔(0.35[95%CI,0.35-0.36])和 1-4 岁诊断的患者(0.50[95%CI,0.50-0.51])。入组率因诊断组而异,白血病、骨髓增生性疾病、骨髓增生异常性疾病(0.55[95%CI,0.54-0.55])和肾肿瘤(0.55[95%CI,0.53-0.58])的入组率最高。在调整诊断年份和癌症诊断后,COG 治疗性试验开放期间 CCRN 的入组率增加了 3.1%[95%CI,0.6-5.6%]。
结论:尽管仅入组了新诊断病例的 36%,但 CCRN 仍然是从事儿童癌症病因学和生存研究的研究人员的宝贵资源。本研究的结果可能为提高当前和未来 COG 非治疗性登记研究协议的入组率提供依据。
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