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International benchmarking of stage at diagnosis for six childhood solid tumours (the BENCHISTA project): a population-based, retrospective cohort study

  • 0Evaluative Epidemiology Unit, Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
The Lancet. Child & Adolescent Health +

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January 24, 2025

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January 24, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Childhood cancer stage at diagnosis varies significantly by geographic region for several tumor types. This highlights the need for earlier detection and standardized diagnostic investigations to improve outcomes.

Area Of Science

  • Pediatric Oncology
  • Cancer Epidemiology
  • Global Health

Background

  • International survival rates for childhood cancers vary, potentially due to differences in diagnosis stage.
  • The BENCHISTA project aimed to investigate geographical disparities in childhood tumor staging.

Purpose Of The Study

  • To assess geographical variation in tumor stage at diagnosis for six common childhood solid tumors.
  • To apply the international consensus Toronto Childhood Cancer Stage Guidelines across population-based cancer registries.

Main Methods

  • A retrospective cohort study involving 67 cancer registries across Europe, Australia, Brazil, Japan, and Canada.
  • Application of Toronto Guidelines to stage incident cases of neuroblastoma, medulloblastoma, Wilms tumor, Ewing sarcoma, rhabdomyosarcoma, and osteosarcoma diagnosed between 2014-2017.
  • Statistical comparison of stage distribution and multivariable logistic models to identify geographical variations in metastatic disease.

Main Results

  • Tumor staging data were analyzed for 10,937 patients; staging was complete for 93.1%.
  • Statistically significant geographical differences in stage distribution were observed for neuroblastoma, Wilms tumor, osteosarcoma, and rhabdomyosarcoma.
  • Proportions of patients with metastases at diagnosis ranged from 18.2% (Wilms tumor) to 50.3% (neuroblastoma), with significant geographical variations for four of the six tumor types.

Conclusions

  • Significant population-level variation exists in the stage at diagnosis for several childhood tumors across geographical areas.
  • Findings underscore the critical need for earlier diagnosis and standardized investigations for distant metastases.
  • Sustained cooperation between cancer registries and clinicians is essential for the standardized use of the Toronto Guidelines to enable ongoing comparisons.