Worldwide trends in population-based survival for children, adolescents, and young adults diagnosed with leukaemia, by subtype, during 2000–14 (CONCORD-3): analysis of individual data from 258 cancer registries in 61 countries

Naomi Ssenyonga*, Charles Stiller, Kayo Nakata, Jaime Shalkow, Sheilagh Redmond, Jean Luc Bulliard, Fabio Girardi, Christine Fowler, Raphael Marcos-Gragera, Audrey Bonaventure, Nathalie Saint-Jacques, Pamela Minicozzi, Prithwish De, Miguel Rodríguez-Barranco, Siri Larønningen, Veronica Di Carlo, Margit Mägi, Mikhail Valkov, Karri Seppä, Dyfed Wyn HuwsMichel P. Coleman, Claudia Allemani, Sabiha Bouzbid, Mokhtar Hamdi-Chérif, Lamia Kara, Kaouel Meguenni, Derbali Regagba, Sine Bayo, Traore Cheick Bougadari, Shyam Shunker Manraj, Karima Bendahhou, Akinade Ladipo, Olufemi Ogunbiyi, Nontuthuzelo Somdyala, María Agustina Chaplin, Florencia Moreno, Gladis Calabrano, Silvia Espinola, Beatriz Carballo Quintero, Rosalba Fita, Walter Laspada, Susana Ibañez, Carlos Lima, Allini Mafra Da Costa, Paulo César De Souza, Juliana Chaves, Cyntia Laporte, Maria Paula Curado, Jose Carlos de Oliveira, Claudia Veneziano, CONCORD Working Group

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

25 Citations (Scopus)


Background: Leukaemias comprise a heterogenous group of haematological malignancies. In CONCORD-3, we analysed data for children (aged 0–14 years) and adults (aged 15–99 years) diagnosed with a haematological malignancy during 2000–14 in 61 countries. Here, we aimed to examine worldwide trends in survival from leukaemia, by age and morphology, in young patients (aged 0–24 years). Methods: We analysed data from 258 population-based cancer registries in 61 countries participating in CONCORD-3 that submitted data on patients diagnosed with leukaemia. We grouped patients by age as children (0–14 years), adolescents (15–19 years), and young adults (20–24 years). We categorised leukaemia subtypes according to the International Classification of Childhood Cancer (ICCC-3), updated with International Classification of Diseases for Oncology, third edition (ICD-O-3) codes. We estimated 5-year net survival by age and morphology, with 95% CIs, using the non-parametric Pohar-Perme estimator. To control for background mortality, we used life tables by country or region, single year of age, single calendar year and sex, and, where possible, by race or ethnicity. All-age survival estimates were standardised to the marginal distribution of young people with leukaemia included in the analysis. Findings: 164 563 young people were included in this analysis: 121 328 (73·7%) children, 22 963 (14·0%) adolescents, and 20 272 (12·3%) young adults. In 2010–14, the most common subtypes were lymphoid leukaemia (28 205 [68·2%] patients) and acute myeloid leukaemia (7863 [19·0%] patients). Age-standardised 5-year net survival in children, adolescents, and young adults for all leukaemias combined during 2010–14 varied widely, ranging from 46% in Mexico to more than 85% in Canada, Cyprus, Belgium, Denmark, Finland, and Australia. Individuals with lymphoid leukaemia had better age-standardised survival (from 43% in Ecuador to ≥80% in parts of Europe, North America, Oceania, and Asia) than those with acute myeloid leukaemia (from 32% in Peru to ≥70% in most high-income countries in Europe, North America, and Oceania). Throughout 2000–14, survival from all leukaemias combined remained consistently higher for children than adolescents and young adults, and minimal improvement was seen for adolescents and young adults in most countries. Interpretation: This study offers the first worldwide picture of population-based survival from leukaemia in children, adolescents, and young adults. Adolescents and young adults diagnosed with leukaemia continue to have lower survival than children. Trends in survival from leukaemia for adolescents and young adults are important indicators of the quality of cancer management in this age group. Funding: Children with Cancer UK, the Institut National du Cancer, La Ligue Contre le Cancer, Centers for Disease Control and Prevention, Swiss Re, Swiss Cancer Research foundation, Swiss Cancer League, Rossy Family Foundation, US National Cancer Institute, and the American Cancer Society.

Original languageEnglish
Pages (from-to)409-431
Number of pages23
JournalThe Lancet Child and Adolescent Health
Issue number6
Publication statusPublished - Jun 2022
Externally publishedYes


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