Godoy-Casasbuenas Natalia, Gil Fabian, Arias Nelson, Pérez Claudia Uribe, Cruz Harold Mauricio Casas, Goyes Luisa Bravo, de Vries Esther
Ph.D. Program in Clinical Epidemiology, Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia.
Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotá, Colombia.
Ecancermedicalscience. 2024 Sep 6;18:1759. doi: 10.3332/ecancer.2024.1759. eCollection 2024.
Childhood leukemia (CL) is the most common type of childhood cancer worldwide and in Colombia. Thanks to therapeutic innovations and improved access, the survival of children and adolescents with leukemia has increased considerably worldwide, especially in high-income countries. In Colombia, a middle-income country, survival has also been observed to increase in big cities. However, the survival rate in intermediate cities is still unknown.
This study aimed to assess short- and long-term survival rates of children with leukemia coming from three intermediate Colombian cities as well as to compare overall survival (OS) rates versus relative survival (RS) rates of this population of children.
Data from population-based cancer registries in three Colombian cities (Bucaramanga metropolitan area, Manizales and Pasto) were analyzed. OS and RS of up to 10 years were estimated for children who were diagnosed with leukemia at ages 0-18 years between 1998 and 2018 and followed up for vital status. RS was calculated using the Pohar-Perme method. We performed a separate survival analysis by gender and by period of diagnosis (before and after 2010).
We included data from 507 children and adolescents diagnosed with leukemia. RS at 1, 5 and 10 years after diagnosis were similar between the populations for the respective timeframes (RS Bucaramanga 86.5%, 66.9% and 52.5%; Manizales 81.1%, 62.8% and 61.1%; Pasto 81.7% at 1 year, 66.2% at 5 years and 59.4% at 10 years). OS and RS were very similar for all estimates and periods. There were no clear differences in RS between genders across the three population-based cancer registries and there was an improvement in RS after 2010, particularly in Bucaramanga and Pasto.
Our study reports similar 5-year survival rates for CL in these Colombian cities compared to rates documented in other Latin American countries and larger Colombian cities. These are far below what is reported in high-income settings. This highlights opportunities for improvement in the Colombian health system, where numerous barriers persist in terms of suspicion, diagnosis and continuity of treatment for CL.
儿童白血病（CL）是全球及哥伦比亚最常见的儿童癌症类型。得益于治疗创新和可及性的提高，全球范围内，尤其是在高收入国家，白血病儿童和青少年的生存率有了显著提高。在中等收入国家哥伦比亚，大城市的生存率也有所上升。然而，中等城市的生存率仍然未知。
本研究旨在评估来自哥伦比亚三个中等城市的白血病儿童的短期和长期生存率，并比较该群体儿童的总生存率（OS）和相对生存率（RS）。
分析了哥伦比亚三个城市（布卡拉曼加都会区、马尼萨莱斯和帕斯托）基于人群的癌症登记数据。对1998年至2018年间0至18岁被诊断为白血病并随访生命状态的儿童，估计了长达10年的OS和RS。RS采用波哈尔 - 佩尔梅方法计算。我们按性别和诊断时期（2010年之前和之后）进行了单独的生存分析。
我们纳入了507名被诊断为白血病的儿童和青少年的数据。在各自的时间范围内，各人群诊断后1年、5年和10年的RS相似（布卡拉曼加的RS分别为86.5%、66.9%和52.5%；马尼萨莱斯为81.1%、62.8%和61.1%；帕斯托1年时为81.7%，5年时为66.2%，10年时为59.4%）。所有估计值和时期的OS和RS都非常相似。在这三个基于人群的癌症登记处中，不同性别之间的RS没有明显差异，2010年后RS有所改善，特别是在布卡拉曼加和帕斯托。
我们的研究报告称，这些哥伦比亚城市的CL 5年生存率与其他拉丁美洲国家和哥伦比亚较大城市记录的生存率相似。但这些远远低于高收入地区报告的生存率。这凸显了哥伦比亚卫生系统有待改进的地方，在CL的怀疑、诊断和治疗连续性方面仍然存在许多障碍。
