Childhood and adolescents’ cancer survival: Progress made and priorities for improvement. An Italian population-based study

Background: Population-based cancer registries are crucial to monitor health system performance, inform policy makers and allocate resources effectively. We updated Italian survival estimates for children and adolescents, analysing temporal and geographical differences to evaluate improvements. Methods: Cases were from the Association of Italian Cancer Registries and codified according to the International Classification of Childhood Cancer, 3rd edition. Thirty-one cancer registries provided 9142 incident cases (2013–2017) and 15 cancer registries contributed data for 12,447 incident cases (1998–2017) for trend analysis. We used the period approach to estimate survival in children (0–14 years) and adolescents (15–19 years) during the period 2013–2017. Survival was estimated by age, sex and geographical area of residence. Results: Survival improved over time in both children and adolescents. Among children, significant progress was observed for acute myeloid leukaemia, non-Hodgkin lymphomas, ependymomas, Ewing sarcoma, and acute lymphoid leukaemia. For adolescents, notable improvements were found in non-Hodgkin lymphomas and skin melanomas. However, disparities emerged across Italy, with major differences observed for central nervous system neoplasms and osteosarcoma in children, as well as for acute lymphatic leukaemia and soft tissue sarcomas in adolescents. Conclusion: Increased survival was observed in many Italian children and adolescents with tumours and differences emerged across Italian regions. We will investigate the reasons for these discrepancies in collaboration with clinicians.