Avtor/Urednik		Karalexi, Maria A.; Žagar, Tina
Naslov		Childhood central nervous system tumour mortality and survival in Southern and Eastern Europe (1983-2014)
Tip		članek
Vol. in št.		Letnik 51, št. 17
Leto izdaje		2015
Obseg		str. 2665-2677
ISSN		0959-8049 - European journal of cancer (Oxford, England : 1990)
Jezik		eng
Abstrakt		Childhood central nervous system (CNS) tumour registration and control programs in Southern and Eastern Europe remain thin, despite the lethal nature of the disease. Mortality/survival data were assembled to estimate the burden of malignant CNS tumours, as well as the potential role of sociodemographic survival determinants across 14 cancer registries of this region. Methods Average age-adjusted mortality rates were calculated, whereas time trends were quantified through Poisson and Joinpoint regressions. Kaplan%Meier curves were derived for the maximum and the more recent (10 and 5 year) registration periods. Multivariate Cox regression models were used to assess demographic and disease-related determinants. Results Variations in mortality (8%16 per million) and survival (5-year: 35%69%) were substantial among the participating registries; in most registries mortality trend was stable, whereas Bulgaria, having the highest starting rate, experienced decreasing annual mortality (%2.4%, p = 0.001). A steep decrease in survival rates was evident before the second year of follow-up. After controlling for diagnostic subgroup, age, gender and diagnostic year, Greece seemed to present higher survival compared with the other contributing registries, although the follow-up period was short. Irrespective of country, however, rural residence was found to impose substantial adverse repercussions on survival (hazard ratio (HR): 1.2, 95% confidence interval (CI): 1.1%1.4). Conclusion Cross-country mortality and survival variations possibly reflect suboptimal levels of health care delivery and cancer control in some regions of Southern and Eastern Europe, notwithstanding questionable death certification patterns or follow-up procedures. Continuous childhood cancer registration and linkage with clinical data are prerequisite for the reduction of survival inequalities across Europe.
Proste vsebinske oznake		otroci tumorji centralnega živčnega sistema smrtnost preživetje children central nervous system tumours mortality survival