Trends in childhood cancers at Tygerberg Hospital from 1994 to 2014

Abstract

Background. There is a paucity of data regarding childhood cancer incidence in low-and middle-income countries owing to a lack of disease-specific, hospital-and population-based registries. Objective. To describe the disease profile and outcome of children with cancer, treated at a single institution in South Africa between 1994 and 2014. Methods. Data collected included demographic data (age at diagnosis, sex, stage or risk group, race) and 5-year overall survival (OS) of children aged ≤15 years diagnosed with cancer. Time to event and factors associated with 5-year outcomes were analysed, using Kaplan-Meier curves and Cox regression analysis. Results. The most common malignancies were leukaemia (27.7%), brain tumours (18.4%), lymphomas (14.1%), nephroblastoma (8.0%) and soft-tissue sarcomas (7.4%) for 935 patient records. Limited-disease solid tumours and standard-risk haematological malignancies had good OS rates of 77.7% and 85.9%, respectively, although OS for the whole group was 60.2%. Nephroblastoma (89.3%), retinoblastoma (86.7%), Hodgkin’s lymphoma (89.7%) and Burkitt lymphoma (75.5%) had the best OS. Type of cancer (p<0.01), solid-tumour stage (p<0.001) and risk classification for haematological malignancies (p<0.001) were significantly associated with mortality. Conclusions. Underlying cancer diagnosis, stage and risk group remained significant factors influencing survival with good OS for limited disease in solid tumours and standard-risk haematological malignancies, which was comparable with survival rates in high-income countries.