Irish childhood cancer survivors

Children from deprived backgrounds have the same chance of surviving five years as children from advantaged backgrounds.

A new analysis from Ireland’s National Cancer Registry, the Boyne Research Institute in Drogheda, and Our Lady’s Children’s Hospital, Crumlin, shows that area of residence and socio-economic background had little impact on five-year survival of children of diagnosed with cancer in Ireland. The study (published in the European Journal of Cancer) looked at region of residence and also at socio-economic status, to determine if children who lived further away from major treatment centres or children from more disadvantaged backgrounds were more likely to die before they reached the five-year survival mark.

The National Cancer Registry has been registering patients with cancer, including children, since 1994. Data were analysed for cancers diagnosed between 1994 and 2005. Regional patterns of treatment were assessed to evaluate the impact of centralization of services. The regions examined were Dublin / North-East, Dublin / Mid-Leinster, South and West, based on the HSE administrative regions. An index of deprivation, using Census data on socio-economic variables for small areas of residence, was used to measure disadvantage.

Cancer in children is rare, but seems to be on the increase, although in part this may reflect improvements in diagnostic services. In Ireland, 1450 children aged 0-14 (an average of 120 children per year) were diagnosed with cancer during the study period. The recorded incidence increased from 137 cases per million per year during 1994-97 to 158 per million during 2002-2005. This represents an average percentage increase of 1.5% per year, similar to recent trends for Europe as a whole. Many developed countries have reported increases in occurrence of childhood cancer. The reasons why children get cancer are largely unknown; many factors (including environmental, immunological or genetic) may be operating, both independently and together.

Survival from cancer is usually assessed at five years from diagnosis. The overall five-year survival for Irish children with cancer was 79%. This is very close to the most recent estimates for Europe as a whole.

No clear evidence was found of deprivation-related influences on childhood cancer survival in Ireland, overall or for the three main diagnostic groups – leukaemias, brain tumours and lymphomas.

Likewise, there was little evidence of regional variation in survival, with the possible exception of CNS tumours for which there was significantly higher survival among patients resident in the Western region.

The authors speculate that the absence of clear trends or patterns for regional or deprivation-related variation in survival may reflect a high degree of coordination and uniformity of diagnosis and treatment services, and application of standard treatment protocols nationally. Most children with cancer are treated at major hospitals, where international treatment regimens are in place.