Population-Based Study of Trends in Childhood Cancer Survival in Egypt from the Children's Cancer Hospital Egypt (CCHE), 2007-2017

Background: Childhood cancer is a priority in Egypt due to the large proportion of children with cancer and the limited resources to achieve optimal care and outcomes. Accurate estimates of childhood cancer survival are lacking in Egypt due to paucity of data in population-based cancer registries. We, therefore aimed to estimate survival rates and trends in survival for the largest cohort of children with cancer in Egypt between 2007 and 2017.Methods: We used data from the largest cohort of children with cancer available in Egypt at the Children’s Cancer Hospital 57357–Egypt (CCHE), with population-based analysis. We analyzed routinely collected data of 15,779 children with cancer, aged 0-18 years, diagnosed between 2007-2017, based on ICCC-3 criteria and followed-up until 31st July 2018. Overall survival was estimated using the Kaplan Meier method and trends in survival were determined by single year of diagnosis using Cox regression, and by diagnosis periods using log rank test. Survival rates were stratified by age, gender, cancer type/sub-type, stage at diagnosis and disease risk variables. We also compared age-standardized survival rates from CCHE/Egypt to international benchmarks, identified cancers with significantly lower survival, highlighted potential reasons for inferior outcomes, and provided recommendations in practice and policy to improve survival outcomes.