Projects we fund

Overview

We know that childhood cancer survival chances vary between countries. The chance of a child being cured is affected by how far their cancer has spread at the time they are diagnosed. For solid tumours, measurement of this cancer spread is called ‘tumour stage’: at its most simple, low numbers (stages 1 and 2) mean the cancer is still where it started in the body, high numbers (stage 3 and 4) mean that it has invaded nearby structures or spread to distant parts of the body. Cancer registries (CRs) count all the new cases of cancer in a population and follow up patients to know if they survive. This is called ‘overall survival’ and is measured for all people with cancer. If there are differences in survival rates between populations, this might be explained by differences in the numbers of patients with ‘low’ versus ‘high’ stage tumours at diagnosis or because survival rates for the same stage differ. In some adult cancers, both reasons explain some of the observed survival differences between countries. So far, it has not been possible to compare tumour stage at diagnosis or survival by stage for children’s cancers between countries. This is because measurement systems designed for adult cancers do not apply to children’s cancers and CRs often hold very little information on tumour stage. This project will help CRs use a new international system to measure stage in children’s cancers and make reliable comparisons of survival rates to understand any differences. Prof. Kathy Pritchard-Jones, Dr Gemma Gatta and their international team will analyse patient data from >8,000 children across 26 countries, including the UK, Brazil, Canada, Australia, Japan and across Europe. They will focus their analysis on six different cancer types:

• Medulloblastoma (brain tumour)
• Osteosarcoma (bone tumour)
• Ewing sarcoma (bone tumour)
• Rhabdomyosarcoma (muscle tumour)
• Wilms’ tumour (kidney tumour)
• Neuroblastoma (tumour of adrenal gland and some other sites)

What difference will this project make?

This project will provide the first ever standardised data on children’s tumour stage and survival and will allow meaningful comparisons in patient outcomes across Europe and other westernised countries. By understanding why childhood cancer survival rates still vary across Europe and other developed countries, Prof. Pritchard-Jones and her team could guide countries on how to improve childhood cancer survival rates in their own nations. If the results show that in some countries children are more likely to have higher stage tumours at diagnosis, this suggests that national health service improvement efforts should focus on earlier diagnosis. If the results show differences in the chances of survival for the same tumour stage and type between countries, this suggests that countries should examine whether this is due to variations or delays in how patients are treated. The project will also establish the framework for future international research to continue to monitor and understand why young patients’ survival varies between countries.