Dados do Resumo

Título

Childhood cancer over 20 years in the State of São Paulo: a hospital-based registry study

Introdução

Cancer is the leading cause of death among children and adolescents worldwide. Childhood tumors are considered rare and account for approximately 2% of all cancer cases. These tumors differ from those that develop in adults and often present with nonspecific symptoms, leading to delayed diagnosis and treatment. Monitoring pediatric oncology care is essential for integrating improvement strategies into healthcare services and implementing surveillance and prevention actions for this age group.

Objetivo

To assess the landscape of childhood cancer over the past two decades using data from the hospital-based cancer registries (HBCR) of São Paulo state.

Métodos

We used data from the HBCR database of the Fundação Oncocentro de São Paulo, consolidated in June 2024. The dataset included analytical cases of childhood cancer (defined here as affecting individuals up to 19 years old) diagnosed between 2000 and 2020 in 80 institutions across the state. Analyses were performed based on sex, age group, residence municipality, and treatment facility, grouped by regional health department (RHD), topography, type of treatment, and treatment access indicators. We described absolute and relative frequencies, as well as measures of central tendency. Overall survival probabilities for 1, 3, 5, and 10 years post-diagnosis were calculated for cases diagnosed between 2000 and 2018 and followed up until the end of 2023.

Resultados

A total of 28,184 childhood cancer cases were identified, representing 3.2% of all registered cases (excluding non-melanoma skin cancer). Of these, 53.6% were male and 46.4% female, with most under 14 years old (20,777 cases). Leukemias and myeloproliferative diseases were more common in children (29.5%), while lymphomas and reticuloendothelial neoplasms predominated in adolescents (23.6%). Major migration flows was from Registro (82.0%) and Santos (67.7%) to Grande São Paulo, and from São João da Boa Vista (80.2%) and Piracicaba (63.8%) to Campinas. For cases arriving with a prior diagnosis at the institution, adolescents had a longer median time to treatment initiation compared to children (40 vs. 23 days). Chemotherapy was the most common treatment, more frequent in children (40.7%) than adolescents (24.9%). By the end of 2023, 68% of patients were alive, with a 10-year overall survival rate of 63%, higher among children.

Conclusões

This overview of childhood cancer over a 20-year period highlights the need for targeted strategies for early diagnosis and effective treatment, influencing the increased survival probabilities in this population. It also underscores the importance of equitable access to healthcare services, given the significant migration to major treatment centers, indicating the need to evaluate the infrastructure and capacity of these centers to manage regional demand.

Palavras Chave

Hospital-based cancer registry; Childhood cancer; Survival