Survival in Children Below the Age of 15 Years With Leukemia: Temporal Patterns in Eastern and Western Germany Since German Reunification

Temporal patterns of childhood cancer survival 1991 to 2016: A nationwide register‐study based on data from the German Childhood Cancer Registry

“…The remarkable increase in AML survival is in line with findings from international observations 22,25,26,47,62‐65 . Within Europe, the increase in AML survival was observed much earlier in Finland and Northern England than in Switzerland and Estonia where treatment to standardised protocols has been implemented several years later 22,65 .…”

“…For Germany in particular, socioeconomic circumstances in Eastern federal states were quite similar to those in other Eastern European countries before German reunification (1990). Indeed, a previous study from the GCCR showed that 5‐year OS for LL was lower in Eastern Germany during the 1990s compared to Western Germany and was followed by strong improvements 64 …”

“…The remarkable increase in AML survival is in line with findings from international observations. 22,25,26,47,[62][63][64][65] Within Europe, the increase in AML survival was observed much earlier in Finland and Northern England than in Switzerland and Estonia where treatment to standardised protocols has been implemented several years later. 22,65 Similar to our study of Germany, the findings from Northern England and EUROCARE indicated that the previously lower LL survival in boys has caught up to the girls' level, 19,23,25 while reports from France and Switzerland still observed this sex gap in more recent years.…”

“…We know that clinical factors for risk stratification have a major impact on treatment and prognosis, but so do socioeconomic and cultural factors, which differ between and within countries, and may influence both healthcare provision and individual resources-even within Europe. 18,64,68 Apparently, not all affected children benefit equally from the remarkable advances in diagnostics and treatment, since children with cancer across Europe continue to experience inequalities in accessing the best available diagnostics, treatments (including clinical trial participation) and supportive care. These disparities contribute to differences in survival and are of greater concern in Eastern European countries than in Northern and Western Europe.…”

“…Indeed, a previous study from the GCCR showed that 5-year OS for LL was lower in Eastern Germany during the 1990s compared to Western Germany and was followed by strong improvements. 64 An overview of the international comparison of patterns in childhood cancer survival is given in Table S5.…”