Global surveillance of survival from haematological malignancies in children, teenagers and young adults
Dr Claudia Allemani
London School of Hygiene and Tropical Medicine
London WC1E 7HT
1 January 2018
It is well known that childhood leukaemias and lymphomas are among the most common cancers diagnosed in children and teenagers world-wide. However, in some countries they are not recognised as a public health priority.
Many countries have a National Cancer Plan (NCP), a strategy to tackle cancer through prevention, diagnosis, treatment, care and research. However, NCPs are not in place in all countries, and when they are, they do not always take into consideration the specificities of cancers in children, teenagers and young adults. Therefore, diagnostic and treatment strategies for childhood, teenage and young adult cancer (TYA) vary across the world, as does survival.
In this study Dr Allemani and her team will examine the differences in world-wide survival of children and young adults who were diagnosed with leukaemia or lymphoma under 25 years of age, during 2000-2014. The study team will analyse data which has been collected from population-based cancer registries through the CONCORD programme, the international study of global surveillance of cancer survival.
The CONCORD programme is designed to compare cancer survival internationally and over time. The third cycle of the programme (CONCORD-3) included over 87,000 children diagnosed with acute lymphoblastic leukaemia, the most common type of leukaemia in children, and over 41,000 children diagnosed with lymphoma, in more than 60 countries. The results, published in 2018, highlighted wide geographical disparities in 5-year survival, ranging from less than 70% to more than 90% for children diagnosed with acute lymphoblastic leukaemia or lymphoma during 2010-2014.
In this study the research team will estimate the proportion of children and TYA who are “cured” from cancer, in high- and in low- and middle-income countries. They will also estimate the time between diagnosis and population “cure”, where it can be said to occur. The statistical definition of “cure” is different from that used in clinical practice. In survival analyses, groups of survivors reach “cure” when they no longer have a higher risk of dying than the general population of children of the same age.
This project will generate robustly comparable information on survival for children, teenagers and young adults with leukaemia and lymphoma diagnosed up to 2014 in many countries around the world.
The results, in particular on “cure”, will provide information for clinicians and parents on trends in survival up to 5 years after diagnosis of a leukaemia or lymphoma. The results will inform health policy, by providing policy-makers with the information required to assess the effectiveness of cancer health services. Survival is already used as a tool for implementing and monitoring the effectiveness of several European cancer care plans. Ultimately, the results should help guide the inclusion of actions in National Cancer Plans that are specific to children and adolescents with cancer, aiming to improve access to diagnosis and effective curative treatments for children, teenagers and young adults with haematological malignancy in many countries.
This project is led by Dr Claudia Allemani, Associate Professor of Cancer Epidemiology at the London School of Hygiene and Tropical Medicine. Dr Allemani’s background covers the range from applied mathematics to public health and education, via epidemiology and medical statistics. She was elected a Fellow of the UK Higher Education Academy in July 2012, and an Honorary Member of the UK Faculty of Public Health (FPH) in March 2014. She was awarded the Faculty’s inaugural Global Public Health Award in June 2016.
Dr Allemani, co-Principal Investigator of the CONCORD programme for global surveillance of cancer survival trends, will collaborate closely with Professor Michel Coleman who initiated the CONCORD programme in 1999 and with about 600 collaborators in 70 countries world-wide, including epidemiologists, statistician, clinicians, and experts in cancer registration. She will also work alongside members for the CONCORD Central Analytic Team, including skilled researchers with backgrounds in public health, epidemiology, mathematics, statistics, cancer registration and medicine, with wide experience in international research collaborations.