Geographical comparison of cancer survival in European children (1988–1997): Report from the Automated Childhood Cancer Information System project


      The aim of this study was to assess regional survival differences among childhood cancer patients in Europe. For this exercise, the Automated Childhood Cancer Information System (ACCIS) database was utilised. Survival data from 54 population-based cancer registries on 49,651 childhood cancer patients aged 0–14 years and diagnosed in 1988–1997 were analysed using life-table method. Overall, the 5-year survival was 72% among all patients, varying from 62% to 77% between the five geographical regions. The East region generally had lower survival rates than the rest of Europe. The geographical differences indicate the need for more co-ordination, systematisation and standardisation in diagnosis, referral and the treatment of childhood cancers in Europe. Increase of resources is necessary to improve the lower survival in the East region. Continuing data collection on a European level will facilitate monitoring of population-based survival of childhood cancer patients.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to European Journal of Cancer
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


      1. Capocaccia R, Gatta G, Magnani C, Stiller C, Coebergh J-W, editors. Childhood cancer survival in Europe 1978–1992: the EUROCARE study. Eur J Cancer 2001;37:671–816.

        • Levi F.
        • La Vecchia C.
        • Negri E.
        • Lucchini F.
        Childhood cancer mortality in Europe, 1955–1995.
        Eur J Cancer. 2001; 37: 785-809
        • Steliarova-Foucher E.
        • Stiller C.
        • Kaatsch P.
        • et al.
        Geographical patterns and time trends of cancer incidence and survival among children and adolescents in Europe since 1970s: the ACCIS project.
        Lancet. 2004; 364: 2087-2105
      2. Kramárová E, Stiller CA, Ferlay J, et al. International classification of childhood cancer 1996. IARC technical report no. 29. Lyon: International Agency for Research of Cancer; 1996.

        • Berkson J.
        • Gage R.P.
        Calculations of survival rates for cancer.
        Proc Staff Meet Mayo Clin. 1950; 5: 270-286
        • Kalbfleisch J.D.
        • Prentice R.L.
        The statistical analysis of failure time data.
        John Wiley & Sons, New York1980
        • Ederer F.
        • Axtell L.M.
        • Cutler S.J.
        The relative survival rate: a statistical methodology.
        Natl Cancer Inst Monogr. 1961; 6: 101-121
      3. WHO Statistical Information System (WHOSIS). WHO mortality database. 4th January 2005. Available from

        • Kirkwood B.
        Essentials of medical statistics.
        Blackwell Scientific Publications, Oxford1988
        • Parkin D.M.
        • Hakulinen T.
        Analysis of survival.
        in: Jensen O.M. Parkin D.M. MacLennan R. Muir C.S. Skeet R.G. Cancer Registration: principles and methods. IARC scientific publications no. 95. International Agency for Research on Cancer, Lyon1991: 175-176
      4. Ries L.A.G. Eisner M.P. Kosary C.L. SEER cancer statistics review, 1975–2000. National Cancer Institute, Bethesda, MD2003 (Available from)
        • Terracini B.
        • Coebergh J.W.
        • Gatta G.
        • et al.
        Childhood cancer survival in Europe: an overview.
        Eur J Cancer. 2001; 37: 810-816
        • Gatta G.
        • Corazziari I.
        • Magnani C.
        • Peris-Bonet R.
        • Roazzi P.
        • Stiller C.
        The EUROCARE Working Group. Childhood cancer survival in Europe.
        Ann Oncol. 2003; 14: v119-v127
        • Gustafsson G.
        • Schmiegelow K.
        • Forestier E.
        • et al.
        Improving outcome through two decades in childhood ALL in the Nordic countries: the impact of high-dose methotrexate in the reduction of CNS irradiation. Nordic Society of Pediatric Haematology and Oncology (NOPHO).
        Leukemia. 2000; 14: 2267-2275
        • Mott M.G.
        • Mann J.R.
        • Stiller C.A.
        The United Kingdom Children’s Cancer Study Group the first 20 years of growth and development.
        Eur J Cancer. 1997; 33: 1448-1452
        • Ablett S.
        • Pinkerton C.R.
        • United Kingdom Children’s Cancer Study Group (UKCCSG)
        Recruiting children into cancer trials – role of the United Kingdom Children’s Cancer Study Group (UKCCSG).
        Br J Cancer. 2003; 88: 1661-1665
        • Möller T.R.
        • Garwicz S.
        • Barlow L.
        • et al.
        Decreasing late mortality among five-year survivors of cancer in childhood and adolescence: a population based study in the Nordic countries.
        J Clin Oncol. 2001; 19: 3173-3181