Childhood cancer mortality high in UK in children

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Children with cancer in Britain do not live as long as those with the disease in other European countries, according to British researchers who urged politicians to invest more to address the problem.

One reason may be that British children receive less effective initial treatment and less intensive treatment after a relapse, they said. 

Writing in the Lancet Oncology journal on Wednesday, they added that British children were less likely to undergo the kind of regular check ups with a paediatrician that could show up early signs of a tumour.

“Routine health-surveillance recommendations in the UK are guided by the publication Health for All Children, and these guidelines are not as thorough as previous recommendations, with few routine examinations,” the researchers wrote.

The authors said the results of two major comparative studies showed survival from childhood cancer was lower in Britain compared with other European countries.

Alan Craft, of the Institute of Child Health, Newcastle, northeast England, and Kathy Pritchard-Jones, of the Royal Marsden Hospital and Institute of Cancer Research, focused on a form of cancer called Wilms’ tumour.

Wilms’ tumour is one of the most common childhood tumours, and the most common type of kidney cancer. It usually occurs in children under the age of five.

Over the past 15 years, British children with Wilms’ tumour have had a survival rate of 83 percent, worse than the 89 percent rate reported for northern and Western Europe, the researchers said.

The reason seems to be early diagnosis stemming from the kind of routine and thorough check ups other European children receive, they said.

Trials on Wilms’ tumour in Germany showed that between 1994 and 2001, about 28 percent of patients had their cancer first identified during a visit to the doctor’s for an unrelated problem.

This compares to just 11 percent of patients at the Royal Marsden Hospital in London and 4 percent of patients referred to the Newcastle Hospital or the Royal Victoria Infirmary, the researchers said.

“This difference in timing or diagnosis could account for much of the difference in survival between the UK and Germany,” the researchers wrote. “Intensive routine surveillance of children… might not be cost effective, but it could make a difference to survival from Wilms’ tumour.”

The researchers say multinational clinical trials are needed to pursue the findings further and primary care of children in Britain needs to be more rigorous.

Politicians also need to make sure they approve a high enough level of spending to ensure that Britain catches up with the rest of Europe, they added. 

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