American Cancer Society; Centers for Disease Control and Prevention; Swiss Re; Swiss Cancer Research foundation; Swiss Cancer League; Institut National du Cancer; La Ligue Contre le Cancer; Rossy Family Foundation; US National Cancer Institute; and the Susan G Komen Foundation.

SummaryBackgroundGlobal inequalities in access to health care are reflected in differences in cancer survival. The CONCORD programme was designed to assess worldwide differences and trends in population-based cancer survival. In this population-based study, we aimed to estimate survival inequalities globally for several subtypes of childhood leukaemia.MethodsCancer registries participating in CONCORD were asked to submit tumour registrations for all children aged 0–14 years who were diagnosed with leukaemia between Jan 1, 1995, and Dec 31, 2009, and followed up until Dec 31, 2009. Haematological malignancies were defined by morphology codes in the International Classification of Diseases for Oncology, third revision. We excluded data from registries from which the data were judged to be less reliable, or included only lymphomas, and data from countries in which data for fewer than ten children were available for analysis. We also excluded records because of a missing date of birth, diagnosis, or last known vital status. We estimated 5-year net survival (ie, the probability of surviving at least 5 years after diagnosis, after controlling for deaths from other causes [background mortality]) for children by calendar period of diagnosis (1995–99, 2000–04, and 2005–09), sex, and age at diagnosis (<1, 1–4, 5–9, and 10–14 years, inclusive) using appropriate life tables. We estimated age-standardised net survival for international comparison of survival trends for precursor-cell acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML).FindingsWe analysed data from 89 828 children from 198 registries in 53 countries. During 1995–99, 5-year age-standardised net survival for all lymphoid leukaemias combined ranged from 10·6% (95% CI 3·1–18·2) in the Chinese registries to 86·8% (81·6–92·0) in Austria. International differences in 5-year survival for childhood leukaemia were still large as recently as 2005–09, when age-standardised survival for lymphoid leukaemias ranged from 52·4% (95% CI 42·8–61·9) in Cali, Colombia, to 91·6% (89·5–93·6) in the German registries, and for AML ranged from 33·3% (18·9–47·7) in Bulgaria to 78·2% (72·0–84·3) in German registries. Survival from precursor-cell ALL was very close to that of all lymphoid leukaemias combined, with similar variation. In most countries, survival from AML improved more than survival from ALL between 2000–04 and 2005–09. Survival for each type of leukaemia varied markedly with age: survival was highest for children aged 1–4 and 5–9 years, and lowest for infants (younger than 1 year). There was no systematic difference in survival between boys and girls.InterpretationGlobal inequalities in survival from childhood leukaemia have narrowed with time but remain very wide for both ALL and AML. These results provide useful information for health policy makers on the effectiveness of health-care systems and for cancer policy makers to reduce inequalities in childhood cancer survival.FundingCanadian Partnership Against Cancer, Cancer Focus Northern Ireland, Cancer In...

The distribution of ovarian cancer histology varies widely worldwide. Type I epithelial, germ cell and sex cord-stromal tumours are generally associated with higher survival than type II tumours, so the proportion of these tumours may influence survival estimates for all ovarian cancers combined. The distribution of histological groups should be considered when comparing survival between countries and regions.

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Introducción: El objetivo del presente escrito es proporcionar una guía de análisis de la pertinencia en los cuidados paliativos como una necesidad imperiosa, se analiza la tasa de mortalidad con la relación de la necesidad de este servicio en la provincia del Guayas. Métodos: El presente estudio descriptivo cuali y cuantitativo; se consultó el archivo estadístico del Instituto Oncológico Nacional “Dr. Juan Tanca Marengo” Solca-Guayaquil y el INEC. Se consultó la incidencia de cáncer del período 2008–2012 de las ciudades de Guayaquil, Quito, Cuenca, Loja y provincia de Manabí. Se utilizó un estudio de mercado en 100 usuarios del área médica para la implementación de la especialidad en cuidados paliativos, diseñada por la Asociación Latinoamericana de Cuidados Paliativos (ALCP). Resultados: en Guayaquil la tasa de incidencia de cáncer en hombres es de 142.1 y mujeres 165.5, mientras que en Quito en hombres es 228.1 por cada 100 mil habitantes, y 230.1 en mujeres por cada 100 mil habitantes. La tasa de crecimiento por cáncer es del 4 % anual. En la encuesta 100 trabajadores de la salud, 100 % consideró muy necesaria la especialidad de cuidados paliativos, el 93 % desconoce si se oferta la especialidad, 100 % respondió que las universidades deberían ofertar esta especialidad, de los 9 temas que se deben abordar en la especialidad de cuidados paliativos, el tratamiento del dolor tema fue considerado el más relevante por el 100 % de los encuestados. La Universidad Católica de Santiago de Guayaquil fue elegida por el 86 % de los encuestados y el centro escogido para el desarrollo de la especialización fue Solca, en el 100 % de los encuestados. Conclusión: Se infiere que es sumamente importante contar con programas de posgrado para iniciar la formación de especialistas en Cuidados Paliativos debido a que es un personal profesional estratégico, para elevar los estándares de calidad de vida de la población. Ecuador no registra atención profesional paliativista y las Facultades de Ciencias Médicas en Ecuador no registran programas académicos.