Objective: Of children diagnosed with cancer, approximately one fourth die of the disease or disease related complications. The aim of this study was to investigate survival and causes of death in children with cancer in Iceland. 

Methods: This study is retrospective; population based and includes all children, less than 18 years of age, diagnosed with cancer in Iceland from 1981 to 2006. Information was extracted from the Icelandic Cancer Registry, patients hospital records and data from Statistics Iceland.

Results:Of 279 children diagnosed with cancer in the research period 215 were alive at the end of 2008. The overall 5-year survival was 81.2% and 10-year survival was 76.7%. There was not a significant survival difference with respect to age at diagnosis, year of diagnosis, gender or geographical residence. The small cohort size could be the explanation. Eleven individuals developed secondary neoplasm, eight of whom died. Sixteen of the 64 nonsurvivors were treated with curative intent until death, 12 of them died of therapy related complications.

Conclusions: Survival rate in childhood cancer in Iceland is comparable to other Western countries. As previously reported, prognosis of patients with secondary neoplasm is unfavorable. Therapy related complications are the most common cause of death in patients treated with curative intent.

Figure 1. Survival in 279 children <18 years old, boys 159 and girls 120 diagnosed with cancer in Iceland 1981-2006, (p=0,8174).

Figure 2. Five and ten year survival of the most prevalent cancer types. In parenthesis are the number of cases diagnosed in the study period.

 

Table I.  Cases diagnosed with secondary neoplasms. Time in years from the diagnosis of primary neoplasm  to the diagnosis of secondary neoplasm. Mortality at the end of the research period (31.12.2008). ¹Time from diagnosis of primary neoplasm to the diagnosis of the latter secondary neoplasm.

Table II. Causes of death in patients undergoing treatment with curative intent. ¹ Pulmonary tumor embolism and veno-occlusive diseaseleading to multiorgan failure.