International Collaboration Reveals Key Insights into Childhood Cancer Survival Rates
A global research initiative, the BENCHISTA project (International Benchmarking of Childhood Cancer Survival), is shedding light on the disparities in survival rates for children and adolescents with cancer across different countries. The project, supported by organizations like Children with Cancer UK and the Italian Association for Cancer Research (AIRC), aims to understand why these variations exist and identify areas for improvement in cancer care worldwide. Recent findings, published in JAMA Network Open and Cancers, highlight the critical role of early diagnosis and standardized staging procedures.
Understanding the BENCHISTA Project
The BENCHISTA project is a collaborative effort involving cancer registries, clinicians, and researchers from over 27 countries, including Europe, Australia, Brazil, Japan, and Canada. The project focuses on six common childhood solid tumors: medulloblastoma (brain tumor), osteosarcoma and Ewing sarcoma (bone tumors), rhabdomyosarcoma (soft tissue), Wilms tumor (kidney), and neuroblastoma (adrenal gland and other sites). Researchers are comparing three-year survival rates in these cancers, correlating them with the stage of the disease at diagnosis – a key factor influencing prognosis.
A key component of the project is the use of the Toronto International Staging Guidelines for Pediatric Cancers, ensuring standardized data collection and comparability across different regions. This involves providing online training, help desks, translations of the guidelines, and rigorous quality control tests for participating cancer registries.
BENCHISTA-ITA: A National Perspective
The BENCHISTA-ITA project, the Italian branch of the international initiative, is funded by AIRC and supported by the Italian Association of Tumor Registries (AIRTUM) and the Italian Association of Pediatric Hemato-Oncology (AIEOP). It analyzes data from children and adolescents diagnosed between 2013 and 2017 with the six core tumors studied by the broader BENCHISTA project, as well as astrocytoma, ependymoma, and retinoblastoma. The project aims to explain variations in survival rates within Italy and in comparison to other European countries.
BENCHISTA-ITA has collected data on approximately 1,400 cases, representing around 80% of the Italian child population with these cancers. Data analysis uses standardized statistical methods to estimate and compare three-year overall survival rates between regions (North, Centre, South, and Islands).
Key Findings from Recent Studies
Analysis of nearly 10,000 cases from 73 cancer registries in 27 countries revealed a clear trend: three-year overall survival decreases as the stage of the cancer at diagnosis increases. Specifically, three-year survival rates were highest for Wilms tumor (95%) and lowest for osteosarcoma (75%).
Significant geographic variations in age-adjusted survival were observed for neuroblastoma, medulloblastoma, Ewing sarcoma, and rhabdomyosarcoma. However, when stage at diagnosis was taken into account, some of these regional differences diminished, suggesting that variations in staging practices may contribute to observed survival disparities.
A separate study focusing on neuroblastoma in Italy, analyzing data from approximately 80% of Italian children with the disease, showed high survival rates in localized stages (95%), but significantly lower prognosis in metastatic cases (79%). No significant regional differences were observed in either stage at diagnosis or outcomes within Italy.
Beyond Early Diagnosis: Factors Influencing Survival
While early diagnosis is crucial, the research emphasizes that it is not the sole determinant of survival. Other factors play a significant role, including the organization of basic pediatric care, access to specialist care, therapeutic strategies, the quality and organization of healthcare systems, and the completeness and precision of staging procedures.
“Our project not only highlights the importance of collecting high-quality data and strengthening cooperation between doctors and population-based cancer registries, but also constitutes a key tool for uncovering the reasons for survival differences between countries for children with cancer,” says statistician Laura Botta of the IRCCS Foundation National Cancer Institute of Milan.
Looking Ahead
The BENCHISTA project continues to evolve, with Phase 2 expanding to include more registries, longer follow-up periods, and deeper analysis of treatment and demographic data. The ultimate goal is to generate insights that can improve outcomes for children with cancer globally and reduce inequalities in access to quality care.