Childhood cancer survival and avoided deaths in Australia, 1983–2016

Article

Youlden, Danny R., Baade, Peter D., Moore, Andrew S., Pole, Jason D., Valery, Patricia C. and Aitken, Joanne F.. 2023. "Childhood cancer survival and avoided deaths in Australia, 1983–2016." Paediatric and Perinatal Epidemiology. 37 (1), pp. 81-91. https://doi.org/10.1111/ppe.12895
Article Title

Childhood cancer survival and avoided deaths in Australia, 1983–2016

ERA Journal ID13743
Article CategoryArticle
AuthorsYoulden, Danny R., Baade, Peter D., Moore, Andrew S., Pole, Jason D., Valery, Patricia C. and Aitken, Joanne F.
Journal TitlePaediatric and Perinatal Epidemiology
Journal Citation37 (1), pp. 81-91
Number of Pages11
Year2023
PublisherJohn Wiley & Sons
Place of PublicationUnited Kingdom
ISSN0269-5022
Digital Object Identifier (DOI)https://doi.org/10.1111/ppe.12895
Web Address (URL)https://onlinelibrary.wiley.com/doi/10.1111/ppe.12895
Abstract

Background
Large improvements in childhood cancer survival have been reported over recent decades. Data from cancer registries have the advantage of providing a ‘whole of population’ approach to gauge the success of cancer control efforts.

Objectives
The aim of this study was to investigate recent survival estimates for children diagnosed with cancer Australia and to examine the extent of changes in survival over the last 35 years. For the first time, we also estimated the number of deaths among Australian children that were potentially avoided due to improvements in survival.

Methods
A retrospective, population-based cohort study design was used. Case information was extracted from the Australian Childhood Cancer Registry for 1983–2016, with follow-up to 31 December 2017. Eligible children were aged 0–14 with a basis of diagnosis other than autopsy or death certificate only. Five-year relative survival was calculated using the semi-complete cohort method for three diagnosis periods (1983–1994, 1995–2006 and 2007–2016), and changes in survival over time were assessed via flexible parametric models. Avoided deaths within 5 years for those diagnosed between 1995 and 2016 were estimated under the assumption that survival rates remained the same as for 1983–1994.

Results
Overall 5-year survival within the study cohort (n = 20,871) increased from 72.8% between 1983 and1994 to 86.1% between 2007 and 2016, equating to an adjusted excess mortality hazard ratio of 1.82 (95% confidence interval 1.67, 1.97). Most cancers showed improvements in survival; other gliomas, hepatoblastoma and osteosarcoma were exceptions. Among children diagnosed between 1995 and 2016, 38.7% of expected deaths within 5 years of diagnosis (n = 1537 of 3970) were avoided due to temporal improvements in survival.

Conclusions
Survival for childhood cancer has continued to improve over recent years, thanks mainly to ongoing progress in treatment development combined with improved supportive care. Providing innovative measures of survival, such as avoided deaths, may assist with understanding outcome data produced by cancer registries.

KeywordsAustralia; avoided deaths; survival; registries; child; cancer
ANZSRC Field of Research 20204299. Other health sciences
Byline AffiliationsCancer Council Queensland, Australia
Griffith University
Queensland University of Technology
Queensland Children's Medical Research Institute, Australia
University of Queensland
QIMR Berghofer Medical Research Institute, Australia
Institute for Resilient Regions
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Chambers, Suzanne K., Scuffham, Paul A., Baade, Peter D., Lowe, Anthony P., Dunn, Jeff, Galvao, Daniel A., Gordon, Louisa, Smith, David P., Sandoe, David F., Wootten, Addie C., Spry, Nigel A., Gardiner, Robert A., Davis, Ian D. and Newton, Robert U.. 2015. "Advancing prostate cancer survivorship research in Australia." Cancer Forum. 39 (3), pp. 204-209.
A systematic review of the impact of stigma and nihilism on lung cancer outcomes
Chambers, Suzanne K., Dunn, Jeffrey, Occhipinti, Stefano, Hughes, Suzanne, Baade, Peter, Sinclair, Sue, Aitken, Joanne, Youl, Pip and O'Connell, Dianne L.. 2012. "A systematic review of the impact of stigma and nihilism on lung cancer outcomes." BMC Cancer. 12 (184). https://doi.org/10.1186/1471-2407-12-184
The impact of body mass index and physical activity on mortality among patients with colorectal cancer in Queensland, Australia
Baade, Peter D., Meng, Xingqiong, Youl, Philippa H., Aitken, Joanne F., Dunn, Jeff and Chambers, Suzanne K.. 2011. "The impact of body mass index and physical activity on mortality among patients with colorectal cancer in Queensland, Australia." Cancer Epidemiology, Biomarkers and Prevention. 20 (7), pp. 1410-1420. https://doi.org/10.1158/1055-9965.EPI-11-0079
A multilevel investigation of inequalities in clinical and psychosocial outcomes for women after breast cancer
Youl, Philippa H., Baade, Peter D., Aitken, Joanne F., Chambers, Suzanne K., Turrell, Gavin, Pyke, Christopher and Dunn, Jeffrey. 2011. "A multilevel investigation of inequalities in clinical and psychosocial outcomes for women after breast cancer." BMC Cancer. 11. https://doi.org/10.1186/1471-2407-11-415
The influence of high-intensity compared with moderate-intensity exercise training on cardiorespiratory fitness and body composition in colorectal cancer survivors: a randomised controlled trial
Devin, James L., Sax, Andrew T., Hughes, Gareth I., Jenkins, David G., Aitken, Joanne F., Chambers, Suzanne K., Dunn, Jeffrey C., Bolam, Kate A. and Skinner, Tina L.. 2016. "The influence of high-intensity compared with moderate-intensity exercise training on cardiorespiratory fitness and body composition in colorectal cancer survivors: a randomised controlled trial." Journal of Cancer Survivorship. 10 (3), pp. 467-479. https://doi.org/10.1007/s11764-015-0490-7
A five-year prospective study of quality of life after colorectal cancer
Chambers, Suzanne K., Meng, Xingqiong, Youl, Pip, Aitken, Joanne, Dunn, Jeff and Baade, Peter. 2012. "A five-year prospective study of quality of life after colorectal cancer." Quality of Life Research. 21 (9), pp. 1551-1564. https://doi.org/10.1007/s11136-011-0067-5
Epidemiology of prostate cancer in the Asia-Pacific region
Baade, Peter D., Youlden, Danny R., Cramb, Susanna M., Dunn, Jeff and Gardiner, Robert A.. 2013. "Epidemiology of prostate cancer in the Asia-Pacific region." Prostate International. 1 (2), pp. 47-58. https://doi.org/10.12954/PI.12014
A longitudinal study of post-traumatic growth and psychological distress in colorectal cancer survivors
Occhipinti, Stefano, Chambers, Suzanne K., Lepore, Stephen, Aitken, Joanne and Dunn, Jeff. 2015. "A longitudinal study of post-traumatic growth and psychological distress in colorectal cancer survivors." PLoS One. 10 (9). https://doi.org/10.1371/journal.pone.0139119
Location of residence and breast cancer stage: a SEER population-based analysis
Brandon, Lindsay, Youl, Pip, Baade, Peter, Whiteside, Eliza and Kimlin, Michael. 2015. "Location of residence and breast cancer stage: a SEER population-based analysis." The Breast Journal. 21 (6), pp. 693-695. https://doi.org/10.1111/tbj.12499
Lifetime ultraviolet exposure estimates for selected population groups in south east Queensland
Parisi, A. V., Meldrum, L. R., Wong, J. C. F., Aitken, J. and Fleming, R. A.. 1999. "Lifetime ultraviolet exposure estimates for selected population groups in south east Queensland." Physics in Medicine and Biology. 44 (12), pp. 2947-2953. https://doi.org/10.1088/0031-9155/44/12/307
Effect of childhood and adolescent ultraviolet exposures on cumulative exposure in south east Queensland schools
Parisi, A. V., Meldrum, L. R., Wong, J. C. F., Aitken, J. and Fleming, R. A.. 2000. "Effect of childhood and adolescent ultraviolet exposures on cumulative exposure in south east Queensland schools." Photodermatology, Photoimmunology and Photomedicine. 16 (1), pp. 19-24. https://doi.org/10.1034/j.1600-0781.2000.160106.x
Evaluation of differences in ultraviolet exposure during weekend and weekday activities
Parisi, A. V., Meldrum, L. R., Kimlin, M. G., Wong, J. C. F., Aitken, J. and Mainstone, J. S.. 2000. "Evaluation of differences in ultraviolet exposure during weekend and weekday activities." Physics in Medicine and Biology. 45 (8), pp. 2253-2262. https://doi.org/10.1088/0031-9155/45/8/314