Trends in survival after childhood cancer in Europe, 1978-1997: report from the Automated Childhood Cancer Information System project (ACCIS).

This study, originating in the Automated Childhood Cancer Information System (ACCIS), evaluated the time trend in survival after childhood cancer in Europe. The study included more than 72,000 childhood cancer cases aged 0-14 years diagnosed in 1978-1997 and followed-up in 30 population-based cancer registries with a long history of registration and follow-up, in 15 European countries. Survival was analysed using an actuarial life-table method. Five-year cumulative survival probability increased significantly over the study period for all tumour types combined, from 54% for cases diagnosed in the period 1978-1982 to 75% in 1993-1997. Significant improvement was also observed in 10-year survival. Comparing the results for the period 1993-1997 with those for 1978-1982, the largest relative increase in survival was seen for hepatic tumours (32%) and the largest reduction in mortality for non-Hodgkin's lymphomas (60%). Least progress was seen for central nervous system (CNS) tumours. The improvement was statistically significant in all European regions and was most rapid in the East. The ranking among the European regions did not change over the study period, with highest survival in the North and the West and lowest in the East. Extended data collection is necessary to evaluate future time trends and changes in differences between European regions.