Childhood cancer: Survival, treatment modalities, late effects and improvements over time

Erdmann, Friederike; Frederiksen, Line Elmerdahl; Bonaventure, Audrey; Mader, Luzius; Hasle, Henrik; Robison, Leslie L.; Winther, Jeanette Falck

doi:10.1016/j.canep.2020.101733

Cited by 166 publications

(166 citation statements)

References 140 publications

(109 reference statements)

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“…However, not all children benefit equally from these improvements and survival varies widely by cancer type, age at clinical onset, stage of disease (in solid tumours), and somatic genetic lesions. Timely diagnosis is essential for good prognosis and preventing advanced disease, which commonly requires more intensive therapy and involves a higher risk of treatment-induced side and late effects [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Impact of the COVID-19 pandemic on incidence, time of diagnosis and delivery of healthcare among paediatric oncology patients in Germany in 2020: Evidence from the German Childhood Cancer Registry and a qualitative survey

Erdmann

Wellbrock

Trübenbach

et al. 2021

The Lancet Regional Health - Europe

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Background The indirect impact of the COVID-19 pandemic on cancer care and timely diagnosis is of increasing concern. We investigated the impact of the COVID-19 pandemic on incidence, time of diagnosis and delivery of healthcare among paediatric oncology patients in Germany in 2020. Methods We analysed incident paediatric cancer cases diagnosed in 0- to 17-year olds in Germany in 2020 using data of the German Childhood Cancer Registry. Absolute numbers and age-standardised incidence rates (ASR) in 2020 were compared to the previous five years (2015–2019). Moreover, we conducted a survey with open-ended questions, gathering perceptions of the diagnostic process and healthcare delivery for paediatric oncology patients during the COVID-19 pandemic. Findings More or similar numbers of paediatric cancer patients were newly diagnosed each month throughout 2020 in comparison to the previous five years. The estimated ASRs showed markedly higher incidence rates, overall and across diagnostic groups, in 2020 compared to 2015-2019. Results from the qualitative survey indicated that diagnostic processes, timeliness of diagnosis, and delivery of treatment were hardly affected during the COVID-19 pandemic. However, psychosocial supportive care and non-urgent appointments were considerably reduced during the lockdown periods. Interpretation We found no indications of severe adverse effects of the COVID-19 pandemic on diagnosis and delivery of healthcare among children with cancer in Germany. The underlying reasons of the increase in incidence rates remain speculative. Continued close monitoring of incidence patterns may shed light on the underlying reasons of the present increase and contribute to understanding disease aetiology. Funding None

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Section: Introductionmentioning

confidence: 99%

Impact of the COVID-19 pandemic on incidence, time of diagnosis and delivery of healthcare among paediatric oncology patients in Germany in 2020: Evidence from the German Childhood Cancer Registry and a qualitative survey

Erdmann

Wellbrock

Trübenbach

et al. 2021

The Lancet Regional Health - Europe

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“…Today, more than 80% of all children with cancer survive for at least 5 years after their initial diagnosis 1 . Therefore, an increasing number of cancer patients survive until adulthood, and attention is shifting towards the reduction of adverse effects and evaluation of long‐term health consequences.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of and factors influencing vitamin D deficiency in paediatric patients diagnosed with cancer at northern latitudes

et al. 2021

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Aim To investigate the prevalence of vitamin D deficiency among children with non‐haematological malignancies and to explore possible causes of low vitamin D levels among these patients. Methods We performed a cross‐sectional study of 458 children diagnosed with solid tumours, brain tumours, non‐Hodgkin lymphoma or Hodgkin disease at the University Children's Hospital, Uppsala, Sweden. Serum 25‐hydroxyvitamin D and parathyroid hormone levels were measured in samples taken at the time of cancer diagnosis and related to clinical data. Vitamin D deficiency was defined as a 25‐hydroxyvitamin D level below 50 nmol/L. Results The prevalence rate of vitamin D deficiency among children with non‐haematological malignancies was 41%. There was no association between sex or diagnosis and vitamin D status. Vitamin D deficiency was more common among school children than preschool children (51% vs. 24%). Older age, season outside summer, and a more recent calendar year were significant predictors of lower 25‐hydroxyvitamin D. There was a significant, albeit weak, negative correlation between 25‐hydroxyvitamin D and parathyroid hormone. Conclusion Vitamin D deficiency is common among children diagnosed with cancer, particularly among school‐aged children diagnosed outside summer. The prevalence appears to be increasing, underlining the need for adequate replacement of vitamin D in these patients.

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“…Cancer among children is rare with an estimated age-standardized incidence rate of 173·3 per million person-years (world standard population) in Western Europe [1] . Nevertheless, cancer is one of the most dreaded diseases in children with far-reaching adverse somatic, psychological or social consequences for later life and is the leading cause of disease-related deaths among children 1–15 years in the western world [ 2 , 3 ]. In Denmark, the incidence of childhood cancer (0–19 years) has increased during the past decades from around 161 per million person-years in the 1970′s to around 195 per million person-years in recent years [4] .…”

Section: Introductionmentioning

confidence: 99%

Air pollution exposure at the residence and risk of childhood cancers in Denmark: A nationwide register-based case-control study

et al. 2020

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Background The etiology of childhood cancer is poorly understood. The role of environmental factors, including air pollution (AP) exposure, has been addressed previously, but results so far have been inconclusive. In this study, we investigate the association between long-term AP exposures in relation to childhood cancer subtypes in Denmark (1981–2013). Methods We conducted a nationwide register-based case-control study. We identified 7745 incident cases of childhood cancers (<20 years) in the Danish Cancer Registry. Four randomly selected (cancer-free) controls were matched to each case according to sex and date of birth. We modelled concentrations of nitrogen dioxide (NO 2 ), fine particles (PM 2·5 ), and black carbon (BC) at all addresses and calculated a time-weighted average from birth to index-date with a state-of-the-art multiscale AP modelling system. We analyzed the risk of childhood cancer in conditional logistic regression models adjusted for socio-demographic variables obtained from registers at the individual and neighborhood level. Findings The main analyses included 5045 cases and 18,179 controls. For all cancers combined, we observed odds ratios (ORs) and 95% confidence intervals (95% CI) of 0·97 (0·94, 1·01) per 10 µg/m 3 NO 2 , 0·89 (0·82, 0·98) per 5 µg/m 3 PM 2·5 , and 0·94 (0·88, 1·01) per 1 µg/m 3 BC, respectively. Most notably, we observed a higher risk of Non-Hodgkin Lymphoma (NHL) with higher childhood AP exposure with ORs and 95% CIs of 1·21 (0·94, 1·55) per 10 µg/m 3 NO 2 , 2·11 (1·10, 4·01) per 5 µg/m 3 PM 2·5 , and 1·68 (1·06, 2·66) per 1 µg/m 3 BC, respectively. We observed indications of increased risks for other types of childhood cancer, however, with very wide CIs including 1. Interpretations The findings of this nation-wide study propose a role of AP in the development of childhood NHL, but more large-scale studies are needed. Funding NordForsk Project #75007.

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Childhood cancer: Survival, treatment modalities, late effects and improvements over time

Cited by 166 publications

References 140 publications

Impact of the COVID-19 pandemic on incidence, time of diagnosis and delivery of healthcare among paediatric oncology patients in Germany in 2020: Evidence from the German Childhood Cancer Registry and a qualitative survey

Impact of the COVID-19 pandemic on incidence, time of diagnosis and delivery of healthcare among paediatric oncology patients in Germany in 2020: Evidence from the German Childhood Cancer Registry and a qualitative survey

Prevalence of and factors influencing vitamin D deficiency in paediatric patients diagnosed with cancer at northern latitudes

Air pollution exposure at the residence and risk of childhood cancers in Denmark: A nationwide register-based case-control study

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