1. Assessing the feasibility and validity of the Toronto Childhood Cancer Stage Guidelines: a population-based registry study
- Author
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Aitken, Joanne F., Youlden, Danny R., Moore, Andrew S., Baade, Peter D., Ward, Leisa J., Thursfield, Vicky J., Valery, Patricia C., Green, Adèle C., Gupta, Sumit, Frazier, A. Lindsay, Aitken, Joanne F., Youlden, Danny R., Moore, Andrew S., Baade, Peter D., Ward, Leisa J., Thursfield, Vicky J., Valery, Patricia C., Green, Adèle C., Gupta, Sumit, and Frazier, A. Lindsay
- Abstract
Background: Cancer stage at diagnosis is crucial for assessing global efforts to increase awareness of childhood cancer and improve outcomes. However, consistent information on childhood cancer stage is absent from population cancer registries worldwide. The Toronto Childhood Cancer Stage Guidelines, compiled through an international consensus process, were designed to provide a standard framework for collection of information on stage at diagnosis of childhood cancers. We aimed to assess the feasibility of implementing the Toronto Guidelines within a national population cancer registry. Methods: We did a population-based registry study using data from the Australian Childhood Cancer Registry and included data from children aged 0–14 years diagnosed between Jan 1, 2006, and Dec 31, 2010 with one of 16 childhood cancers listed in the Toronto Guidelines (acute lymphoblastic leukaemia, acute myeloid leukaemia, Hodgkin's lymphoma, non-Hodgkin lymphoma, neuroblastoma, Wilms' tumour, rhabdomyosarcoma, non-rhabdomyosarcoma soft tissue sarcoma, osteosarcoma, Ewing's sarcoma, retinoblastoma, hepatoblastoma, testicular cancer, ovarian cancer, medulloblastoma, and ependymoma). We extracted data from medical records, and assigned stage according to the Tier 1 criteria (basic) and Tier 2 criteria (more detailed, requiring data from cytology, imaging, and other diagnostic tests, where available) using computer algorithms derived from the Toronto Guidelines. Additionally, expert reviewers independently assigned Tier 2 stage to a random subsample of 160 cases (ten per malignancy type). Feasibility of the guidelines was assessed on the percentage of cases that could be staged, agreement between stage assigned by the algorithms and the expert reviewers, and the mean time (min) taken to collect the required data. Findings: We obtained data for 1412 eligible children. Stage could be assigned according to Tier 2 criteria for 1318 (93%) cases, ranging from 48 (84%) of 57 cases of non
- Published
- 2018