Patterns of childhood cancer mortality: America, Asia and Oceania.

Age-standardised mortality rates for childhood cancers for the calendar period 1950-1989 were reviewed for 22 countries (Canada, U.S.A., 10 Latin American countries or territories, Egypt, seven countries or territories from Asia, Australia and New Zealand) using data from the World Health Organization database. The highest mortality rates (between 6 and 7.5/100,000 boys, between 5 and 6/10,000 girls) for all childhood neoplasms were registered in Latin American countries (Uruguay, Cuba, Argentina, Costa Rica), Kuwait, New Zealand and Singapore. Rates were low in most developed countries, such as Canada, U.S.A., Australia, Japan and Israel (3.5 to 4.5/100,000). The pattern was similar for leukaemias, which account for approximately 50% of all childhood cancer mortality. From the 1960s onwards, a 50% decline in childhood cancer mortality was observed in the U.S.A. and Canada, and substantial declines were also observed in other developed countries, such as Australia, Israel and Japan. The pattern was much less favourable for other areas of the world, including Latin America and a few countries from Asia for which there were data. These declines in childhood cancer mortality are essentially attributable to improved management of the disease. The delay observed in the decline in mortality for most developing countries emphasises the scope and the importance of extending adequate treatments for childhood cancers to these areas of the world.