038 Survival from childhood and young adult cancer in the north of England, 1968–2005
Objective To investigate survival from cancer in children and young adults resident in the North of England.
Methods Cases aged 0–24 years diagnosed with a primary malignancy during the period 1968–2005 were obtained from the Northern Region Young Persons' Malignant Disease Registry. Survival rates at five years were calculated using Kaplan- Meier estimation, for each diagnostic group, within four successive time periods 1968–1977, 1978–1987, 1988–1997 and 1998–2005. Cox regression analysis was used to investigate factors that may influence survival. Analyses were carried out separately by gender and age group (0–14, 15–24 years).
Results There were a total of 5917 cancer cases; 2958 aged 0–14 years (1659 males, 1299 females) and 2949 aged 15–24 years (1592 males, 1357 females). For childhood cancer (aged 0–14) five year survival rates for all cancers improved significantly (P<0.0001) from 39% in 1968-1977 to 60% in 1978-1987, 75% in 1988-1997 and 79% in 1998-2005. From the earliest to the latest period the survival rate for leukaemia increased from 24% to 81% (P<0.0001), lymphoma from 46% to 87% (P<0.0001), central nervous system tumours (CNS) from 43% to 73% (P<0.0001), sympathetic nervous system tumours from 17% to 66% (P<0.0001), bone tumours from 21% to 75% (P<0.0001), soft tissue sarcoma from 30% to 58% (P=0.0001) and for germ cell tumours from 59% to 97% (P=0.0002). Cox analysis showed worse survival for acute lymphocytic leukaemia (ALL) and astrocytoma in the age group 10-14 years. For cancer in teenage and young adults (aged 15–24) five year survival rates for all cancers improved from 47% in 1968–1977 to 62% in 1978-1987, 75% in 1988–1997 and 83% in 1998–2005. From the earliest to the latest period the survival rate for leukaemia increased from 2% to 57% (P<0.0001), lymphoma from 66% to 87% (P<0.0001), CNS tumours from 52% to 81% (P=0.002), bone tumours from 35% to 55% (P=0.02), germ cell tumours from 41% to 95% (P<0.0001) and carcinomas from 56% to 93% (P<0.0001). Survival was worse for ALL in the age group 20–24 years but better for non-Hodgkin lymphoma.
Conclusions There have been marked improvements in survival from childhood and young adult cancer in the North of England over the last four decades. Future work should analyse geographical and socio-demographic patterns for survival rates.