The CONCORD programme was the first to establish global surveillance of cancer survival. The third cycle (CONCORD-3) collected data from 322 cancer registries in 71 countries. Survival from all brain tumours combined varied widely between countries, particularly in children. We propose to examine survival trends by relevant explanatory variables to help explain these disparities.
We present the numbers of children diagnosed with a glioma (ICD-O-3 morphology codes 938-948) and by each of the main glioma subtypes. Five-year net survival will be estimated by morphology, WHO grade, topography, sex, country and calendar period of diagnosis. Net survival is the probability that patients survive their cancer until a given time since diagnosis (e.g. 5 years), after controlling for competing risks of death (background mortality).
Data were obtained for 56,507 children (aged 0-14 years) diagnosed with a glioma: 19,080 in Europe, 26,751 in North America, 6,111 in Asia, 3,103 in Central and South America, 1,379 in Oceania and 83 in Africa. In Europe, 5% of gliomas were ependymomas, 26% pilocytic astrocytomas, 8% astrocytomas, not otherwise specified (NOS), 5% glioblastomas NOS and 15% medulloblastomas NOS. The distribution was similar in North America. In Africa, Asia, and Central and South America, and in Oceania, pilocytic astrocytoma was less frequent (10%-13%) than in Europe or North America. In Africa, Asia, and Central and South America, astrocytoma NOS was more common (11-32%). The frequency of medulloblastoma was higher in Central and South America (28%) and Asia (23%). The distribution of the morphologic subtypes of childhood glioma varies widely around the world. Survival differs between morphologic groups. We will assess the extent to which the distribution of morphologic sub-types contributes to international variation in childhood glioma survival worldwide.
When comprehensive survival analyses are available for each type of glioma, this project will become the benchmark for future international comparisons of brain tumour survival in children, to inform cancer control plans.
Clinical trial identification
Legal entity responsible for the study
London School of Hygiene and Tropical Medicine.
Children With Cancer UK.
All authors have declared no conflicts of interest.