Survival rates among Canadian children and teenagers with cancer diagnosed between 1985 and 1988.

PURPOSE

To describe the survival rates among Canadian children and teenagers with cancer diagnosed between 1985 and 1988 using population-based data, specifically for the more common forms of childhood cancer, and to assess the effect of age at diagnosis and sex as prognostic factors for selected childhood cancers.

DESIGN

Retrospective survival study based on incident cases of cancer identified by the National Cancer Incidence Reporting System and follow-up ascertained by computer record linkage to the Canadian Mortality Database.

SUBJECTS

A total of 4409 patients with cancer first diagnosed at 19 years of age or younger between 1985 and 1988, and followed up to Dec. 31, 1991.

MAIN OUTCOME MEASURES

Survival rates calculated at 1, 3 and 5 years according to the actuarial life table and the proportional hazards models.

RESULTS

The 5-year survival rate for all cancers combined was 71%. Females with acute lymphoblastic leukemia and astrocytoma had markedly higher survival rates than their male counterparts (p < 0.05). Age at diagnosis was a significant predictor of survival among children with acute lymphoblastic leukemia or acute nonlymphoblastic leukemia (p < 0.01), infants having a substantially poorer prognosis than older children. Conversely, the survival rate among infants with neuroblastoma was higher than that among older children, 87% surviving for 5 years after diagnosis.

CONCLUSIONS

The survival rate among Canadian children and teenagers with cancer is favourable in relation to the rate among adults with cancer. Nonetheless, the 5-year survival rates for several childhood cancers remain poor (i.e., less than 65%). The survival rates among Canadian children with cancer are similar to those among children with cancer in other developed countries.