Determinants of survival in children with cancer in Johannesburg, South Africa

Background: Childhood cancer, although rare, remains an important cause of death worldwide. The outcomes of children with all cancer types in South Africa are not well-documented. Aim: The aim of the article was to determine local childhood cancer survival rates and establish determinants of surviv...

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Autores principales:	Nadia Beringer, Kate G. Bennett, Janet E. Poole, Jennifer A. Geel
Formato:	article
Lenguaje:	EN
Publicado:	AOSIS 2021
Materias:	childhood cancer survival risk factors undernutrition ethnicity stage south africa Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/14ae1a06d4fc4f49bca5c1d6672230c4
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spelling	oai:doaj.org-article:14ae1a06d4fc4f49bca5c1d6672230c42021-11-24T07:48:46ZDeterminants of survival in children with cancer in Johannesburg, South Africa2518-87042523-064610.4102/sajo.v5i0.189https://doaj.org/article/14ae1a06d4fc4f49bca5c1d6672230c42021-10-01T00:00:00Zhttps://sajo.org.za/index.php/sajo/article/view/189https://doaj.org/toc/2518-8704https://doaj.org/toc/2523-0646Background: Childhood cancer, although rare, remains an important cause of death worldwide. The outcomes of children with all cancer types in South Africa are not well-documented. Aim: The aim of the article was to determine local childhood cancer survival rates and establish determinants of survival. Setting: The study was conducted at a state and a private hospital in South Africa. Methods: This retrospective cohort study consecutively included all children with a proven malignancy from 01 January 2012 to 31 December 2016. Univariable and multivariable analyses were used to establish which factors significantly impacted overall survival (OS). Results: Of a total of 677 study participants, 71% were black South Africans. The estimated 5-year overall survival (OS) was 57% (95% confidence interval [CI]: 53-61%) and significant determinants of OS on the multivariable analysis included: ethnicity, cancer-type and nutritional status. White and Indian patients had higher OS compared to black patients (hazard ration [HR] (95% CI) 0.46 (0.30-0.69) p = 0.0002 and HR (95%) 0.38 (0.19-0.78) p = 0.0087, respectively). Underweight patients had inferior survival (HR (95% CI) 1.78 (1.28-2.47)) p = 0.0006. Patients with neuroblastoma had an increased risk of dying compared to those with leukaemia (HR [95% CI] 1.78 [1.08-2.94]) p = 0.025. Progression of disease was the most common cause of death, followed by disease relapse. Conclusion: The childhood cancer survival rate obtained in this study can be used as a baseline to facilitate improvement. Non-modifiable prognostic factors included ethnicity and cancer-type whilst modifiable risk factors included undernutrition. Undernutrition should be addressed on a national and local level to improve survival.Nadia BeringerKate G. BennettJanet E. PooleJennifer A. GeelAOSISarticlechildhood cancersurvivalrisk factorsundernutritionethnicitystagesouth africaNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENSouth African Journal of Oncology, Vol 5, Iss 0, Pp e1-e9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	childhood cancer survival risk factors undernutrition ethnicity stage south africa Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	childhood cancer survival risk factors undernutrition ethnicity stage south africa Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Nadia Beringer Kate G. Bennett Janet E. Poole Jennifer A. Geel Determinants of survival in children with cancer in Johannesburg, South Africa
description	Background: Childhood cancer, although rare, remains an important cause of death worldwide. The outcomes of children with all cancer types in South Africa are not well-documented. Aim: The aim of the article was to determine local childhood cancer survival rates and establish determinants of survival. Setting: The study was conducted at a state and a private hospital in South Africa. Methods: This retrospective cohort study consecutively included all children with a proven malignancy from 01 January 2012 to 31 December 2016. Univariable and multivariable analyses were used to establish which factors significantly impacted overall survival (OS). Results: Of a total of 677 study participants, 71% were black South Africans. The estimated 5-year overall survival (OS) was 57% (95% confidence interval [CI]: 53-61%) and significant determinants of OS on the multivariable analysis included: ethnicity, cancer-type and nutritional status. White and Indian patients had higher OS compared to black patients (hazard ration [HR] (95% CI) 0.46 (0.30-0.69) p = 0.0002 and HR (95%) 0.38 (0.19-0.78) p = 0.0087, respectively). Underweight patients had inferior survival (HR (95% CI) 1.78 (1.28-2.47)) p = 0.0006. Patients with neuroblastoma had an increased risk of dying compared to those with leukaemia (HR [95% CI] 1.78 [1.08-2.94]) p = 0.025. Progression of disease was the most common cause of death, followed by disease relapse. Conclusion: The childhood cancer survival rate obtained in this study can be used as a baseline to facilitate improvement. Non-modifiable prognostic factors included ethnicity and cancer-type whilst modifiable risk factors included undernutrition. Undernutrition should be addressed on a national and local level to improve survival.
format	article
author	Nadia Beringer Kate G. Bennett Janet E. Poole Jennifer A. Geel
author_facet	Nadia Beringer Kate G. Bennett Janet E. Poole Jennifer A. Geel
author_sort	Nadia Beringer
title	Determinants of survival in children with cancer in Johannesburg, South Africa
title_short	Determinants of survival in children with cancer in Johannesburg, South Africa
title_full	Determinants of survival in children with cancer in Johannesburg, South Africa
title_fullStr	Determinants of survival in children with cancer in Johannesburg, South Africa
title_full_unstemmed	Determinants of survival in children with cancer in Johannesburg, South Africa
title_sort	determinants of survival in children with cancer in johannesburg, south africa
publisher	AOSIS
publishDate	2021
url	https://doaj.org/article/14ae1a06d4fc4f49bca5c1d6672230c4
work_keys_str_mv	AT nadiaberinger determinantsofsurvivalinchildrenwithcancerinjohannesburgsouthafrica AT kategbennett determinantsofsurvivalinchildrenwithcancerinjohannesburgsouthafrica AT janetepoole determinantsofsurvivalinchildrenwithcancerinjohannesburgsouthafrica AT jenniferageel determinantsofsurvivalinchildrenwithcancerinjohannesburgsouthafrica
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Determinants of survival in children with cancer in Johannesburg, South Africa

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