{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T13:54:01Z","timestamp":1790690041028,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T00:00:00Z","timestamp":1612224000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010137","name":"Fondation Sanofi Espoir","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010137","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The lack of accurate population\u2010based information on childhood cancer stage and survival in low\u2010income countries is a barrier to improving childhood cancer outcomes. In our study, data from three population\u2010based registries in sub\u2010Saharan Africa (Abidjan, Harare and Kampala) were examined for children aged under 15. We assessed the feasibility of assigning stage at diagnosis according to Tier 1 of the Toronto Childhood Cancer Stage Guidelines for patients with non\u2010Hodgkin lymphoma [including Burkitt lymphoma (BL)], retinoblastoma and Wilms' tumour. Patients were actively followed\u2010up, allowing calculation of 3\u2010year relative survival by cancer type and registry. Stage\u2010specific observed survival was estimated. The cohort comprised 381 children, of whom half (n = 192, 50%) died from any cause within 3\u2009years of diagnosis. Three\u2010year relative survival varied by malignancy and location and ranged from 17% [95% confidence interval (CI) = 6%\u201033%] for BL in Harare to 57% (95% CI = 31%\u201076%) for retinoblastoma in Kampala. Stage was assigned for 83% of patients (n = 317 of 381), with over half having metastatic or advanced disease at diagnosis (n = 166, 52%). Stage was a strong predictor of survival for each malignancy; for example, 3\u2010year observed survival was 88% (95% CI = 68%\u201096%) and 13% (4%\u201029%) for localised and advanced BL, respectively (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001). These are the first data on stage distribution and stage\u2010specific survival for childhood cancers in Africa. They demonstrate the feasibility of the Toronto Stage Guidelines in a low\u2010resource setting and highlight the value of population\u2010based cancer registries in aiding our understanding of the poor outcomes experienced by this population.<\/jats:p>","DOI":"10.1002\/ijc.33468","type":"journal-article","created":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T08:43:00Z","timestamp":1610700180000},"page":"2685-2691","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Stage at diagnosis and survival by stage for the leading childhood cancers in three populations of <scp>sub\u2010Saharan<\/scp> Africa"],"prefix":"10.1002","volume":"148","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3229-1784","authenticated-orcid":false,"given":"Donald Maxwell","family":"Parkin","sequence":"first","affiliation":[{"name":"Cancer Surveillance Unit International Agency for Research on Cancer  Lyon France"},{"name":"Nuffield Department of Population Health University of Oxford  Oxford UK"},{"name":"African Cancer Registry Network, INCTR  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2721-9083","authenticated-orcid":false,"given":"Danny R.","family":"Youlden","sequence":"additional","affiliation":[{"name":"Cancer Council Queensland  Brisbane Queensland Australia"},{"name":"Menzies Health Institute Queensland Griffith University, Gold Coast  Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inam","family":"Chitsike","sequence":"additional","affiliation":[{"name":"Paediatric Heme\u2010Oncology Unit University of Zimbabwe  Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Chokunonga","sequence":"additional","affiliation":[{"name":"Zimbabwe National Cancer Registry  Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Line","family":"Couitch\u00e9r\u00e9","sequence":"additional","affiliation":[{"name":"Pediatric Unit, Teaching Hospital of Treichville F\u00e9lix Houphou\u00ebt Boigny Universit\u00e9  Abidjan C\u00f4te d'Ivoire"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franck","family":"Gnahatin","sequence":"additional","affiliation":[{"name":"Registre du Cancer d'Abidjan (RCA), Programme National de Lutte contre le Cancer (PNLCa), Minist\u00e8re de la Sant\u00e9 et de l'Hygi\u00e8ne Publique (MSHP)  Abidjan C\u00f4te d'Ivoire"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Nambooze","sequence":"additional","affiliation":[{"name":"Kampala Cancer Registry, College of Health Sciences Makerere University  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Wabinga","sequence":"additional","affiliation":[{"name":"Department of Pathology, College of Health Sciences Makerere University  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne F.","family":"Aitken","sequence":"additional","affiliation":[{"name":"Cancer Council Queensland  Brisbane Queensland Australia"},{"name":"School of Public Health University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,2,2]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(17)30186-9"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(19)30273-6"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(20)30022-X"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(18)30123-2"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.60.6376"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.31723"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/2333794X19849749"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(15)00539-2"},{"key":"e_1_2_10_10_1","unstructured":"ParkinDM FerlayJ JemalA et al. eds.Cancer in Sub\u2010Saharan Africa. IARC Scientific Publications No 167. Lyon France: International Agency for Research on Cancer;2018."},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20910"},{"key":"e_1_2_10_12_1","unstructured":"World Health Organisation.Cancer in Children. 2018.https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/cancer-in-children. Accessed August 18 2020."},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djaa069"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.28322"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.30170"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1159\/000481508"},{"key":"e_1_2_10_17_1","first-page":"1","article-title":"Treatment of Wilms tumor in sub\u2010Saharan Africa: results of the Second French African Pediatric Oncology Group study","volume":"5","author":"Yao AJ","year":"2019","journal-title":"J Glob Oncol"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.canep.2019.02.013"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.27683"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.27813"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.27101"}],"container-title":["International Journal of Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijc.33468","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijc.33468","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijc.33468","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T11:25:07Z","timestamp":1693221907000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ijc.33468"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,2]]},"references-count":20,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2021,6]]}},"alternative-id":["10.1002\/ijc.33468"],"URL":"https:\/\/doi.org\/10.1002\/ijc.33468","archive":["Portico"],"relation":{},"ISSN":["0020-7136","1097-0215"],"issn-type":[{"value":"0020-7136","type":"print"},{"value":"1097-0215","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,2]]},"assertion":[{"value":"2020-09-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-02-02","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}