1. Childhood leukaemia in Great Britain: trends in incidence, survival and ‘cure’ Anjali Shah UK Association of Cancer Registries conference 30 September 2004

2. Malignant disease in children England and Wales, 1981-1990 International Incidence of Childhood Cancer, vol 2, 1999 TypeNo. % Leukaemia3,70533 Brain, spinal cord2,54922 Lymphoma1,13410 Neuroblastoma7977 Soft tissue7767 Other (kidney, …)2,39121 Total11,352100

3. Types of leukaemia in children England and Wales, 1981-1990 International Incidence of Childhood Cancer, vol 2, 1999 TypeNo.% Acute lymphoid2,95980 Acute myeloid59616 Chronic myeloid882 Other622 Total3,705100

4. Objectives To examine long-term trends in: - Relative survival - ‘Cure’ - Incidence and mortality

5. Leukaemia categories 1901-2000 International Classification of Diseases FromICDContentCategories rev. 1901–1Not defined─ 1911–2-3Leukaemia1 1931–4-5Leukaemia, aleukaemia2 1950–6-7Lymphatic, myeloid, monocytic5 1968–8Acute, chronic13 1979–20009Subacute25 WHO, International Classification of Diseases

6. Leukaemia incidence, mortality and survival trends England and Wales, 1911 to 2000

7. Leukaemia incidence and mortality trends England and Wales, 1911 to 2000 – by sex

8. Leukaemia incidence and mortality trends England and Wales, 1911 to 2000: 1-4 years Incidence Mortality

9. 1993-97 1971-74 1988-92 1983-87 1979-82 1975-78 Childhood leukaemia survival by period of diagnosis Great Britain, 1971 to 1997

10. 1993-97 1988-92 Childhood ALL survival by period of diagnosis Great Britain, 1971 to 1997 1993-97 1988-92 1983-87 1979-82 1975-78 1971-74

11. 1993-97 Childhood AML survival by period of diagnosis Great Britain, 1971 to 1997 1993-97 1988-92 1983-87 1979-82 1975-78 1971-74

12. “cured” patients Relative survival and population ‘cure’ ‘Cured’ patients

13. “cured” patients Relative survival and population ‘cure’ ‘Cured’ patients Tm

14. “cured” patients Relative survival and population ‘cure’ ‘Cured’ patients TmTc

15. 1993-97 Childhood leukaemia ‘cure’ by sex Great Britain, 1971 to 1997

16. 1993-97 Childhood leukaemia ‘cure’ by type of leukaemia Great Britain, 1971 to 1997 ALL ANLL ALL AML

17. 1993-97 Time to ‘cure’ by type of leukaemia Great Britain, 1971 to 1997 ALL ANLL ALL AML ALL AML

18. Summary Incidence has increased by 20% between 1971 and 2000 by 24% in 1-4 year olds Survival has increased from 31% in 1971 to 77% in 1997 It is possible to estimate ‘cure’ by period analysis ‘Cure’ is estimated to have increased to 71%

19. Acknowledgements Office for National Statistics Childhood Cancer Research Group Clinical Trials Service Unit Funding Foundation for Children with Leukaemia