Partners: Joint Research Center – Cancer Information Unit of the European Commission, Romanian Society of Pediatric Oncology-Hematology, Department of Epidemiology and Biostatistics of the Oncological Institute “Ion Chiricuţă” Cluj-Napoca
This is the first time we find out what the survival rate is for pediatric cancer diagnosed in Romania but treated both in Romania and abroad.
We have a complete analysis of the types of cancer affecting children, the most affected age groups, and the regions where most cases occur. Such an analysis is an essential step in aligning with international treatment standards, so that the gaps between the survival rates of children in Romania and those in the West can be reduced.
The study is a working tool for health professionals, experts and public authorities, all involved in increasing the chances of survival of the little ones diagnosed with onco-hematological diseases in Romania.
Graphic presentation of the study here (Romanian language).
COMPLETE RESULTS OF THE STUDY CONCERNING THE SURVIVAL OF CANCER CHILDREN IN ROMANIA
A. The cancer situation in children
- In Romania, about 400 new cases per year are diagnosed and treated in the oncology pediatric network, which, compared to the official reference population of Romania, translates into an annual incidence of about 10 cases per hundred thousand children (incidence most likely underestimated due to reporting to a larger official population than the real one). The incidence remains constant, which indirectly is an indication that reflects how complete the National Register of Child Cancer (RNCCR) is
- In the period 2010-2017, 3708 cases were registered. Most cases are in the age group 0-4 years OLD, and the fewest – adolescents (15-19 years), an underrepresented category in the possible register due to the fact that a significant number of cases occurring after the age of 15 do not reach the pediatric oncology network
- The most frequent tumors are leukemias (31%), followed by lymphomas and tumors of the central nervous system (16%, respectively 14%), and bone tumors and soft tissues (7% each)
B. Survival analysis
- Survival in child cancers has increased steadily in the world (Europe and USA) from 50% -60% in the late 1970s to around 80% in the 1990s, a level that has been maintained in recent years due to limited progress in treatment of cancers with an adverse prognosis (localizations in the central nervous system, bones, soft tissues, myeloid leukemia). It includes both the cases diagnosed and treated in Romania but also the cases that were treated abroad.
- The analysis was carried out in parallel by the specialists of the Biostatistics Department of the Cluj Oncological Institute and the experts of the Joint Research Center – Cancer Information Unit of the European Commission, who reached the same results
- The average survival rate in Romania (for all cancers) is 69.1%, in line with the average of the Eastern European region of 70% (Eastern European countries: Bulgaria, Hungary, Poland, Slovakia, Lithuania, Estonia, Latvia) , 10% lower than the Western European average. Similar to trends in the region and worldwide, survival rates differ significantly by location (below 60% in cancers with poor prognosis and over 80% in cancers with favorable prognosis, for example Hodgkin’s lymphoma, retinoblastoma, Wilms tumor)
- The East-West gap is maintained between 10 and 20% (depending on location) according to the EUROCARE 5 study (the most recent European cancer survival study – for the cases from 1999-2007). A similar gap is between Europe and the United States (especially for locations with poor prognosis: central nervous system, bone, sarcomas)
- The largest gap between Romania and the region average is recorded in the case of bone tumors (43% survival rate in Romania for osteosarcoma compared with 56% Eastern European average, respectively 64.3% European average)
The survival rate of the children diagnosed in Romania in the pediatric oncology centers resulted from this study, does not indicate the situation of the survival of the children treated in our health system and the quality of their life during the treatment received in Romania.
Our next objective in this project is to define the survival rates of the children treated in our country, in each reference center, compared to the children treated in whole or partially abroad. Only then will we have a real situation of the Romanian system and we will be able to make comparisons with other reference systems.
EU experts, authors of the EUROCARE study, attribute the differences in cancer survival between Eastern and Western Europe mainly to differences in resources allocated to the health system, in particular regarding the provision of medicines, the organization of multidisciplinary services, possible delays in diagnosis and treatment, any difficulties in therapeutic management and side effects.
In Romania, the issue of providing cytostatic drugs is always in the spotlight, both in the public opinion and in the authorities, lately a series of measures have been adopted at central level meant to remedy the shortcomings that affect the availability of certain drugs on the market. However, in the procurement mechanisms at local level (especially for the sections with small rolling stock) the supply is still affected by syncope.
On the other hand, equal attention should be paid to ensuring multidisciplinary cooperation in solving cases (especially with surgical specialties), to the path of the cancer patient from child-adolescent-adult (through dedicated services) and to the systematic support for full implementation of recommendations from international profile guides (standards, information systems, logistic support for patient care etc.).