<figure><img src="image_4.png" /></figure>

15–39 years vs 87% in those aged 0–14 years).³¹ Additionally, adolescents and young adults are less likely to be enrolled in clinical trials than children,³ because of the small number of clinical trials in this population, leading to restricted access to novel drugs that could be more effective for adolescents and young adults than for children or older patients.³²

Survival for patients diagnosed with acute myeloid leukaemia was generally poorer than for other subtypes. A similar study in the UK showed that for patients diagnosed with acute myeloid leukaemia in 2001–10, 5-year relative survival was higher in younger age groups (66% in children aged 0–12 years vs 58% in those aged 13–24 years).⁴ We found that children and adolescents with acute myeloid leukaemia had similar survival, whereas young adults had lower survival. Treatment with molecularly targeted tyrosine kinase inhibitors introduced in the early 2000s has led to improved survival for patients with chronic myeloid leukaemia.³³ Survival for chronic myeloproliferative diseases was uniformly higher, with estimates of 90% or higher in most countries during 2000–14. Survival trends for the other subtypes remained fairly steady. Since these subtypes are less common in children, adolescents, and young adults, our results are particularly relevant because, to our knowledge, this is the largest global set of analyses with information about morphological subtypes of leukaemia in young people.

At present, the burden of leukaemia in adolescents and young adults is poorly defined.³⁴ Patients in this age range often have unique clinical needs. Over the past few years, in some parts of the world, adolescents and young adults with leukaemia have increasingly been treated under paediatric protocols, which has led to improved outcomes.³¹ However, this approach has not been adopted worldwide, and survival for adolescents and young adults with leukaemia is often lower than that of children.

In 2018, WHO launched the Global Initiative for Childhood Cancer (GICC), aiming to improve survival for children with cancer worldwide.³⁵ The main target of the GICC is to achieve “at least 60% five-year survival

<caption>**Figure 2:** Age-standardised 5-year net survival from all leukaemias combined for children (0–14 years), adolescents (15–19 years), and young adults (20–24 years) diagnosed during 2010–14, by continent and country</caption>

Survival estimates for each country are ranked from highest to lowest within each continent. High-income countries within each continent are indicated by the dark shades and low-income and middle-income countries are presented by light shades (classified according to World Bank income group). Where data were available for more than one registry in a given country, the survival estimates are derived by pooling the data for that country, but excluding data from registries for which the estimates are considered less reliable. 95% CIs around the net survival estimate are indicated by the error bars for each country. §National estimate not age-standardised. †Data with 100% coverage of the national population. *Data with 100% coverage of the national population for childhood malignancies only; data for 15–24 years, if available, were provided from registries with subnational coverage. ‡National estimate flagged as less reliable because the only available estimates are from a registry or registries in this category.
<figure><img src="image_5.png" /></figure>

15–39 years vs 87% in those aged 0–14 years).³¹ Additionally, adolescents and young adults are less likely to be enrolled in clinical trials than children,³ because of the small number of clinical trials in this population, leading to restricted access to novel drugs that could be more effective for adolescents and young adults than for children or older patients.³²

Survival for patients diagnosed with acute myeloid leukaemia was generally poorer than for other subtypes. A similar study in the UK showed that for patients diagnosed with acute myeloid leukaemia in 2001–10, 5-year relative survival was higher in younger age groups (66% in children aged 0–12 years vs 58% in those aged 13–24 years).⁴ We found that children and adolescents with acute myeloid leukaemia had similar survival, whereas young adults had lower survival. Treatment with molecularly targeted tyrosine kinase inhibitors introduced in the early 2000s has led to improved survival for patients with chronic myeloid leukaemia.³³ Survival for chronic myeloproliferative diseases was uniformly higher, with estimates of 90% or higher in most countries during 2000–14. Survival trends for the other subtypes remained fairly steady. Since these subtypes are less common in children, adolescents, and young adults, our results are particularly relevant because, to our knowledge, this is the largest global set of analyses with information about morphological subtypes of leukaemia in young people.

At present, the burden of leukaemia in adolescents and young adults is poorly defined.³⁴ Patients in this age range often have unique clinical needs. Over the past few years, in some parts of the world, adolescents and young adults with leukaemia have increasingly been treated under paediatric protocols, which has led to improved outcomes.³¹ However, this approach has not been adopted worldwide, and survival for adolescents and young adults with leukaemia is often lower than that of children.

In 2018, WHO launched the Global Initiative for Childhood Cancer (GICC), aiming to improve survival for children with cancer worldwide.³⁵ The main target of the GICC is to achieve “at least 60% five-year survival

<caption>**Figure 2:** Age-standardised 5-year net survival from all leukaemias combined for children (0–14 years), adolescents (15–19 years), and young adults (20–24 years) diagnosed during 2010–14, by continent and country</caption>

Survival estimates for each country are ranked from highest to lowest within each continent. High-income countries within each continent are indicated by the dark shades and low-income and middle-income countries are presented by light shades (classified according to World Bank income group). Where data were available for more than one registry in a given country, the survival estimates are derived by pooling the data for that country, but excluding data from registries for which the estimates are considered less reliable. 95% CIs around the net survival estimate are indicated by the error bars for each country. §National estimate not age-standardised. †Data with 100% coverage of the national population. *Data with 100% coverage of the national population for childhood malignancies only; data for 15–24 years, if available, were provided from registries with subnational coverage. ‡National estimate flagged as less reliable because the only available estimates are from a registry or registries in this category.
by 2030". 5-year net survival for children with cancer in low-income and middle-income countries is typically around 20%, compared to 80% in high-income countries. The GICC includes adolescents (aged 15–19 years) as part of the wider definition of childhood, but including young adults (20–24 years) in the target as well could be an important international priority in countries with limited resources. It would raise awareness of the unique clinical needs of patients in this age group, and would help improve the delivery of effective treatment, further reducing global inequalities in survival, even leading to economic gain.³⁶

The *Lancet Oncology* Commission on childhood cancer suggested that investment in comprehensive scale-up of resource-appropriate interventions worldwide would probably avert approximately 6 million deaths from cancers in children by 2050.³⁷ Treatment of cancer in adolescents and young adults has improved over the past decade and is still progressing. Several high-income countries have developed strategies to improve clinical care and produce better outcomes for this age group.³⁸

The results of this study are population-based survival estimates, derived from cancer registry data that include all patients with cancer diagnosed in the jurisdiction of the registry. Population-based survival estimates reflect the survival of all patients with cancer in the population covered by the registry and reflect the overall effectiveness of the health system.¹⁹,⁴⁰ Clinical trials are excellent for deciding whether one treatment is better than another, but they do not provide information about the effectiveness of the health service in delivering improved treatments to everyone who needs them.

In our study, net survival estimates were produced from data collected according to a common protocol, subject to stringent, centralised quality control and analysed with the same robust statistical methods. Data quality was generally high, but data from some registries in Algeria, China, Thailand, and South Africa contained higher proportions (≥25%) of patients with unspecified leukaemias. This is likely to be due to limited access or no access to specialist haematological pathology services, which can in turn lead to inappropriate treatment for a specific subtype of leukaemia.

<caption>**Figure 3:** 5-year net survival (%) for all leukaemias combined, in patients aged 0–24 years diagnosed during 2000–14, according to World Bank income group and calendar period of diagnosis</caption>

The number of registries for which suitable estimates could be obtained are shown in parentheses. Each box plot shows the range of survival estimates among all cancer registries for which suitable estimates could be obtained for patients diagnosed in each calendar period, in each age group. Survival estimates considered less reliable are not included. The vertical line inside each box represents the median survival estimate among all contributing registries (the central value in the range, or 50th centile). The box covers the IQR. Where there are only a few widely scattered estimates, the median might be close to the lower or upper quartile. The extreme limits of the box plot are 1.5 × IQR below the lower quartile and 1.5 × IQR above the upper quartile. Open circles indicate outlier values outside this range.

<figure><img src="image_5.png" /></figure>
by 2030". 5-year net survival for children with cancer in low-income and middle-income countries is typically around 20%, compared to 80% in high-income countries. The GICC includes adolescents (aged 15–19 years) as part of the wider definition of childhood, but including young adults (20–24 years) in the target as well could be an important international priority in countries with limited resources. It would raise awareness of the unique clinical needs of patients in this age group, and would help improve the delivery of effective treatment, further reducing global inequalities in survival, even leading to economic gain.³⁶

The *Lancet Oncology* Commission on childhood cancer suggested that investment in comprehensive scale-up of resource-appropriate interventions worldwide would probably avert approximately 6 million deaths from cancers in children by 2050.³⁷ Treatment of cancer in adolescents and young adults has improved over the past decade and is still progressing. Several high-income countries have developed strategies to improve clinical care and produce better outcomes for this age group.³⁸

The results of this study are population-based survival estimates, derived from cancer registry data that include all patients with cancer diagnosed in the jurisdiction of the registry. Population-based survival estimates reflect the survival of all patients with cancer in the population covered by the registry and reflect the overall effectiveness of the health system.¹⁹,⁴⁰ Clinical trials are excellent for deciding whether one treatment is better than another, but they do not provide information about the effectiveness of the health service in delivering improved treatments to everyone who needs them.

In our study, net survival estimates were produced from data collected according to a common protocol, subject to stringent, centralised quality control and analysed with the same robust statistical methods. Data quality was generally high, but data from some registries in Algeria, China, Thailand, and South Africa contained higher proportions (≥25%) of patients with unspecified leukaemias. This is likely to be due to limited access or no access to specialist haematological pathology services, which can in turn lead to inappropriate treatment for a specific subtype of leukaemia.

<caption>**Figure 3:** 5-year net survival (%) for all leukaemias combined, in patients aged 0–24 years diagnosed during 2000–14, according to World Bank income group and calendar period of diagnosis</caption>

The number of registries for which suitable estimates could be obtained are shown in parentheses. Each box plot shows the range of survival estimates among all cancer registries for which suitable estimates could be obtained for patients diagnosed in each calendar period, in each age group. Survival estimates considered less reliable are not included. The vertical line inside each box represents the median survival estimate among all contributing registries (the central value in the range, or 50th centile). The box covers the IQR. Where there are only a few widely scattered estimates, the median might be close to the lower or upper quartile. The extreme limits of the box plot are 1.5 × IQR below the lower quartile and 1.5 × IQR above the upper quartile. Open circles indicate outlier values outside this range.

<figure><img src="image_6.png" /></figure>
No internationally recognised set of weights exists for standardising cancer survival estimates across the age range 0–24 years. We therefore derived weights from the age distribution of all patients diagnosed with leukaemia during 2000–14 who were included in our analyses, to enable comparison of summary estimates of survival over time and between countries. The weights used for age standardisation of cancer survival in children have usually been a simple average of the estimates for children aged 0–4, 5–9, and 10–14 years,¹⁹ but patients aged 15–24 years are usually included with adults in the age range 15–44 years, which makes it easier to apply the International Cancer Survival Standard (ICSS) weights.⁴¹ A recently proposed set of weights covers the age range 0–85 years and older.⁴² We rescaled the weights within the age range 0–24 years, and a sensitivity analysis produced similar results (data not shown).

A classification has recently been proposed for adolescents and young adults (15–39 years),⁴³ but as far as we are aware, there is no standard classification that includes children as well as adolescents and young adults. Therefore, we adapted the standard ICCC-3 classification¹⁴ for children (aged 0–14 years) to include those aged 15–24 years.

We will shortly examine trends and inequalities in conditional net survival at 5 years for children, adolescents and young adults with leukaemia who have survived at least 1 year after diagnosis. This is one approach for assessing the impact on 5-year survival of leukaemia treatment (or remission) during the first year after diagnosis. In CONCORD-4, we will also extend the period covered by survival trends to include patients diagnosed in the past 20 years, to bring the global surveillance of survival trends as up to date as possible (2000–19 or later, depending on the availability of data).

In conclusion, this study offers the first worldwide direct comparison of survival between children, adolescents, and young adults diagnosed with leukaemia. The gap in survival between high-income countries and low-income and middle-income countries for children with leukaemia persists, and adolescents and young adults with leukaemia continue to have lower survival than children worldwide. Exploring trends in survival for adolescents and young adults is an important indicator of the quality of cancer management in this age group. Lasting progress in survival will result from investing in the human and financial resources that are required to manage and treat all young people with cancer appropriately, and eventually translating these investments into better outcomes overall.

CONCORD Working Group

*Africa—Algeria:* S Bouzbid (Registre du Cancer d'Annaba); M Hamdi-Chérif*, L Kara (Registre du Cancer de Sétif); K Meguenni, D Regagba (Registre du Cancer Tlemcen); *Mali:* S Bayo, T Cheick Bougadari (Kankou Moussa University); *Mauritius:* SS Manraj (Mauritius National Cancer Registry); *Morocco:* K Bendahhou (Registre du Cancer du Grand Casablanca); *Nigeria:* A Ladipo, OJ Ogunbiyi* (Ibadan Cancer Registry); *South Africa:* NIM Somdyala (Eastern Cape

Province Cancer Registry). *America (Central and South)—Argentina:* MA Chaplin, F Moreno (National Childhood Cancer Registry); GH Calabrano, SB Espinola (Chubut Cancer Registry); B Carballo Quintero, R Fita (Registro Provincial de Tumores de Córdoba); WD Laspada (Registro Provincial de Tumores de Mendoza); SG Ibañez (Population Registry of Cancer of the Province Tierra del Fuego); *Brazil:* CA Lima (Registro de Câncer de Base Populacional de Aracaju); A Mafra Da Costa (Registro de Câncer de Base Populacional da Região de Barretos); PCF De Souza (Registro de Câncer de Base Populacional de Cuiabá); J Chaves, CA Laporte (Registro de Curitiba); MP Curado, JC de Oliveira (Registro de Goiânia); CLA Veneziano, DB Veneziano (Registro de Câncer de Base Populacional de Jaú); ABM Almeida, MRDO Latorre (Registro de Câncer de São Paulo); MS Rebelo, MO Santos (Instituto Nacional de Câncer, Rio de Janeiro); G Azevedo e Silva* (University of Rio de Janeiro); *Chile:* JC Galaz (Registro Poblacional de Câncer Region de Antofagasta); M Aparicio Aravena, J Sanhueza Monsalve (Registro Poblacional de Câncer de la Provincia de Biobio; Registro Poblacional de Câncer Provincia de Concepción); DA Herrmann, S Vargas (Registro Poblacional Region de Los Rios); *Colombia:* VM Herrera, CJ Uribe (Registro Poblacional de Câncer Area Metropolitana de Bucaramanga); LE Bravo, LS Garcia (Cali Cancer Registry); NE Arias-Ortiz, D Morantes (Registro Poblacional de Câncer de Manizales); DM Jurado, MC Yépez Chamorro (Registro Poblacional de Câncer del Municipio de Pasto); *Costa Rica:* S Delgado, M Ramirez (National Registry of Tumors, Costa Rica); *Cuba:* YH Galán Alvarez, P Torres (Registro Nacional de Câncer de Cuba); *Ecuador:* F Martínez-Reyes (Cuenca Tumor Registry); L Jaramillo, R Quinto (Guayaquil Cancer Registry); J Castillo (Loja Cancer Registry); M Mendoza (Manabí Cancer Registry); P Cueva, JG Yépez (Quito Cancer Registry); *France:* B Bhakkan, J Deloumeaux (Registre des cancers de la Guadeloupe); C Joachim, J Macni (General Cancer Registry of Martinique); *Mexico:* R Carrillo, J Shalkow Klincovstein (Centro Nacional para la Salud de la Infancia y la Adolescencia); R Rivera Gomez (Registro Poblacional de Cancer Region Fronteriza Norte de Mexico Zona Tijuana); *Peru:* P Perez, E Poquioma (Lima Metropolitan Cancer Registry); *Puerto Rico:* G Tortolero-Luna, D Zavala (Puerto Rico Central Cancer Registry); *Uruguay:* R Alonso, E Barrios (Registro Nacional de Câncer). *America (North)—Canada:* A Eckstrand, C Nikiforuk (Alberta Cancer Registry); RR Woods (British Columbia Cancer Registry); G Noonan, D Turner* (Manitoba Cancer Registry); E Kumar, B Zhang (New Brunswick Provincial Cancer Registry); JJ Dowden, GP Doyle (Newfoundland & Labrador Cancer Registry); N Saint-Jacques, G Walsh (Nova Scotia Cancer Registry); A Anam, P De (Ontario Cancer Registry); CA McClure, KA Friends (Prince Edward Island Cancer Registry); C Bertrand, AV Ramanakumar (Registre Québécois du Cancer); S Kozie, H Stuart-Panko (Saskatchewan Cancer Agency); USA: T Freeman, JT George (Alabama Statewide Cancer Registry); RM Avila, DK O'Brien (Alaska Cancer Registry); A Holt (Arkansas Central Cancer Registry); L Almon (Metropolitan Atlanta Registry); S Kwong, C Morris (California State Cancer Registry); R Rycroft (Colorado Central Cancer Registry); L Mueller, CE Phillips (Connecticut Tumor Registry); H Brown, B Cromartie (Delaware Cancer Registry); J Ruterbusch, AG Schwartz (Metropolitan Detroit Cancer Surveillance System); GM Levin, B Wohler (Florida Cancer Data System); R Bayakly (Georgia Cancer Registry); KC Ward (Georgia Cancer Registry; Metropolitan Atlanta Registry); SL Gomez, M McKinley (Greater Bay Area Cancer Registry); R Cress (Cancer Registry of Greater California); J Davis, B Hernandez (Hawaii Tumor Registry); CJ Johnson, BM Morawski (Cancer Data Registry of Idaho); LP Ruppert (Indiana State Cancer Registry); S Bentler, ME Charlton (State Health Registry of Iowa); B Huang, TC Tucker* (Kentucky Cancer Registry); D Deapen, L Liu (Los Angeles Cancer Surveillance Program); MC Hsieh, XC Wu (Louisiana Tumor Registry); M Schwenn (Maine Cancer Registry); K Stern (Maryland Cancer Registry); ST Gershman, RC Knowlton (Massachusetts Cancer Registry); G Alverson, T Weaver (Michigan State Cancer Surveillance Program); J Desai (Minnesota Cancer Reporting System); DB Rogers (Mississippi Cancer Registry); J Jackson-Thompson (Missouri Cancer Registry and Research Center); D Lemons, HJ Zimmerman (Montana Central Tumor Registry); M Hood, J Roberts-Johnson (Nebraska Cancer Registry); W Hammond, JR Rees (New Hampshire State Cancer Registry); KS Pawlish, A Stroup (New Jersey State Cancer Registry); C Key,
No internationally recognised set of weights exists for standardising cancer survival estimates across the age range 0–24 years. We therefore derived weights from the age distribution of all patients diagnosed with leukaemia during 2000–14 who were included in our analyses, to enable comparison of summary estimates of survival over time and between countries. The weights used for age standardisation of cancer survival in children have usually been a simple average of the estimates for children aged 0–4, 5–9, and 10–14 years,¹⁹ but patients aged 15–24 years are usually included with adults in the age range 15–44 years, which makes it easier to apply the International Cancer Survival Standard (ICSS) weights.⁴¹ A recently proposed set of weights covers the age range 0–85 years and older.⁴² We rescaled the weights within the age range 0–24 years, and a sensitivity analysis produced similar results (data not shown).

A classification has recently been proposed for adolescents and young adults (15–39 years),⁴³ but as far as we are aware, there is no standard classification that includes children as well as adolescents and young adults. Therefore, we adapted the standard ICCC-3 classification¹⁴ for children (aged 0–14 years) to include those aged 15–24 years.

We will shortly examine trends and inequalities in conditional net survival at 5 years for children, adolescents and young adults with leukaemia who have survived at least 1 year after diagnosis. This is one approach for assessing the impact on 5-year survival of leukaemia treatment (or remission) during the first year after diagnosis. In CONCORD-4, we will also extend the period covered by survival trends to include patients diagnosed in the past 20 years, to bring the global surveillance of survival trends as up to date as possible (2000–19 or later, depending on the availability of data).

In conclusion, this study offers the first worldwide direct comparison of survival between children, adolescents, and young adults diagnosed with leukaemia. The gap in survival between high-income countries and low-income and middle-income countries for children with leukaemia persists, and adolescents and young adults with leukaemia continue to have lower survival than children worldwide. Exploring trends in survival for adolescents and young adults is an important indicator of the quality of cancer management in this age group. Lasting progress in survival will result from investing in the human and financial resources that are required to manage and treat all young people with cancer appropriately, and eventually translating these investments into better outcomes overall.

CONCORD Working Group

*Africa—Algeria:* S Bouzbid (Registre du Cancer d'Annaba); M Hamdi-Chérif*, L Kara (Registre du Cancer de Sétif); K Meguenni, D Regagba (Registre du Cancer Tlemcen); *Mali:* S Bayo, T Cheick Bougadari (Kankou Moussa University); *Mauritius:* SS Manraj (Mauritius National Cancer Registry); *Morocco:* K Bendahhou (Registre du Cancer du Grand Casablanca); *Nigeria:* A Ladipo, OJ Ogunbiyi* (Ibadan Cancer Registry); *South Africa:* NIM Somdyala (Eastern Cape

Province Cancer Registry). *America (Central and South)—Argentina:* MA Chaplin, F Moreno (National Childhood Cancer Registry); GH Calabrano, SB Espinola (Chubut Cancer Registry); B Carballo Quintero, R Fita (Registro Provincial de Tumores de Córdoba); WD Laspada (Registro Provincial de Tumores de Mendoza); SG Ibañez (Population Registry of Cancer of the Province Tierra del Fuego); *Brazil:* CA Lima (Registro de Câncer de Base Populacional de Aracaju); A Mafra Da Costa (Registro de Câncer de Base Populacional da Região de Barretos); PCF De Souza (Registro de Câncer de Base Populacional de Cuiabá); J Chaves, CA Laporte (Registro de Curitiba); MP Curado, JC de Oliveira (Registro de Goiânia); CLA Veneziano, DB Veneziano (Registro de Câncer de Base Populacional de Jaú); ABM Almeida, MRDO Latorre (Registro de Câncer de São Paulo); MS Rebelo, MO Santos (Instituto Nacional de Câncer, Rio de Janeiro); G Azevedo e Silva* (University of Rio de Janeiro); *Chile:* JC Galaz (Registro Poblacional de Câncer Region de Antofagasta); M Aparicio Aravena, J Sanhueza Monsalve (Registro Poblacional de Câncer de la Provincia de Biobio; Registro Poblacional de Câncer Provincia de Concepción); DA Herrmann, S Vargas (Registro Poblacional Region de Los Rios); *Colombia:* VM Herrera, CJ Uribe (Registro Poblacional de Câncer Area Metropolitana de Bucaramanga); LE Bravo, LS Garcia (Cali Cancer Registry); NE Arias-Ortiz, D Morantes (Registro Poblacional de Câncer de Manizales); DM Jurado, MC Yépez Chamorro (Registro Poblacional de Câncer del Municipio de Pasto); *Costa Rica:* S Delgado, M Ramirez (National Registry of Tumors, Costa Rica); *Cuba:* YH Galán Alvarez, P Torres (Registro Nacional de Câncer de Cuba); *Ecuador:* F Martínez-Reyes (Cuenca Tumor Registry); L Jaramillo, R Quinto (Guayaquil Cancer Registry); J Castillo (Loja Cancer Registry); M Mendoza (Manabí Cancer Registry); P Cueva, JG Yépez (Quito Cancer Registry); *France:* B Bhakkan, J Deloumeaux (Registre des cancers de la Guadeloupe); C Joachim, J Macni (General Cancer Registry of Martinique); *Mexico:* R Carrillo, J Shalkow Klincovstein (Centro Nacional para la Salud de la Infancia y la Adolescencia); R Rivera Gomez (Registro Poblacional de Cancer Region Fronteriza Norte de Mexico Zona Tijuana); *Peru:* P Perez, E Poquioma (Lima Metropolitan Cancer Registry); *Puerto Rico:* G Tortolero-Luna, D Zavala (Puerto Rico Central Cancer Registry); *Uruguay:* R Alonso, E Barrios (Registro Nacional de Câncer). *America (North)—Canada:* A Eckstrand, C Nikiforuk (Alberta Cancer Registry); RR Woods (British Columbia Cancer Registry); G Noonan, D Turner* (Manitoba Cancer Registry); E Kumar, B Zhang (New Brunswick Provincial Cancer Registry); JJ Dowden, GP Doyle (Newfoundland & Labrador Cancer Registry); N Saint-Jacques, G Walsh (Nova Scotia Cancer Registry); A Anam, P De (Ontario Cancer Registry); CA McClure, KA Friends (Prince Edward Island Cancer Registry); C Bertrand, AV Ramanakumar (Registre Québécois du Cancer); S Kozie, H Stuart-Panko (Saskatchewan Cancer Agency); *USA:* T Freeman, JT George (Alabama Statewide Cancer Registry); RM Avila, DK O'Brien (Alaska Cancer Registry); A Holt (Arkansas Central Cancer Registry); L Almon (Metropolitan Atlanta Registry); S Kwong, C Morris (California State Cancer Registry); R Rycroft (Colorado Central Cancer Registry); L Mueller, CE Phillips (Connecticut Tumor Registry); H Brown, B Cromartie (Delaware Cancer Registry); J Ruterbusch, AG Schwartz (Metropolitan Detroit Cancer Surveillance System); GM Levin, B Wohler (Florida Cancer Data System); R Bayakly (Georgia Cancer Registry); KC Ward (Georgia Cancer Registry; Metropolitan Atlanta Registry); SL Gomez, M McKinley (Greater Bay Area Cancer Registry); R Cress (Cancer Registry of Greater California); J Davis, B Hernandez (Hawaii Tumor Registry); CJ Johnson, BM Morawski (Cancer Data Registry of Idaho); LP Ruppert (Indiana State Cancer Registry); S Bentler, ME Charlton (State Health Registry of Iowa); B Huang, TC Tucker* (Kentucky Cancer Registry); D Deapen, L Liu (Los Angeles Cancer Surveillance Program); MC Hsieh, XC Wu (Louisiana Tumor Registry); M Schwenn (Maine Cancer Registry); K Stern (Maryland Cancer Registry); ST Gershman, RC Knowlton (Massachusetts Cancer Registry); G Alverson, T Weaver (Michigan State Cancer Surveillance Program); J Desai (Minnesota Cancer Reporting System); DB Rogers (Mississippi Cancer Registry); J Jackson-Thompson (Missouri Cancer Registry and Research Center); D Lemons, HJ Zimmerman (Montana Central Tumor Registry); M Hood, J Roberts-Johnson (Nebraska Cancer Registry); W Hammond, JR Rees (New Hampshire State Cancer Registry); KS Pawlish, A Stroup (New Jersey State Cancer Registry); C Key,
C Wiggins (New Mexico Tumor Registry); AR Kahn, MJ Schymura (New York State Cancer Registry); S Radhakrishnan, C Rao (North Carolina Central Cancer Registry); LK Giljahn, RM Slocumb (Ohio Cancer Incidence Surveillance System); C Dabbs, RE Espinoza (Oklahoma Central Cancer Registry); KG Aird, T Beran (Oregon State Cancer Registry); JJ Rubertone, SJ Slack (Pennsylvania Cancer Registry); J Oh (Rhode Island Cancer Registry); TA Janes, SM Schwartz (Seattle Cancer Surveillance System); SC Chiodini, DM Hurley (South Carolina Central Cancer Registry); MA Whiteside (Tennessee Cancer Registry); S Rai, MA Williams (Texas Cancer Registry); K Herget, C Sweeney (Utah Cancer Registry); AT Johnson (Vermont Cancer Registry); MB Keitheri Cheteri, P Migliore Santiago (Washington State Cancer Registry); SE Blankenship, S Farley (West Virginia Cancer Registry); R Borchers, R Malicki (Wisconsin Department of Health Services); J Espinoza, J Grandpre (Wyoming Cancer Surveillance Program); HK Weir*, R Wilson (Centers for Disease Control and Prevention); BK Edwards*, A Mariotto (National Cancer Institute). Asia—China: N Wang, L Yang (Beijing Cancer Registry); JS Chen, Y Zhou (Changle City Cancer Registry); YT He, GH Song (Cixian Cancer Registry); XP Gu (Dafeng County Center for Disease Control and Prevention); D Mei, HJ Mu (Dalian Centers for Disease Prevention and Control); HM Ge, TH Wu (Donghai County Center for Disease Prevention and Control); YY Li, DL Zhao (Feicheng County Cancer Registry); F Jin, JH Zhang (Ganyu Center for Disease Prevention and Control); FD Zhu (Guanyun Cancer Registry); Q Junhua, YL Yang (Haimen Cancer Registry); CX Jiang (Haining City Cancer Registry); W Biao, J Wang (Jianhu Cancer Registry); QL Li (Jiashan County Cancer Registry); H Yi, X Zhou (Jintan Cancer Registry); J Dong, W Li (Lianyungang Center for Disease Prevention and Control); FX Fu, SZ Liu (Linzhou Cancer Registry); JG Chen, J Zhu (Qidong County Cancer Registry); YH Li, YQ Lu (Sihui Cancer Registry); M Fan, SQ Huang (Taixing Cancer Registry); GP Guo, H Zhaolai (Cancer Institute of Yangzhong City); K Wei (Zhongshan City Cancer Registry); WQ Chen*, W Wei*, H Zeng (The National Cancer Center); *Cyprus: AV Demetriou (Cyprus Cancer Registry); Hong Kong: WK Mang, KC Ngan (Hong Kong Cancer Registry); India: AC Kataki, M Krishnatreya (Guwahati Cancer Registry); PA Jayalekshmi, P Sebastian (Karunagappally Cancer Registry); PS George, A Mathew (Trivandrum Cancer Registry); A Nandakumar* (National Centre for Disease Informatics and Research); Iran: R Malekzadeh, G Roshandel (Golestan Population-based Cancer Registry); Israel: L Keinan-Boker, BG Silverman (Israel National Cancer Registry); Japan: H Ito, Y Koyanagi (Aichi Cancer Registry); M Sato, F Tobori (Akita Prefectural Cancer Registry); I Nakata, N Teramoto (Ehime Prefectural Cancer Registry); M Hattori, Y Kaizai (Fukui Cancer Registry); F Moki (Gunma Prefectural Cancer Registry); H Sugiyama, M Utada (Hiroshima Prefecture Cancer Registry); M Nishimura, K Yoshida (Hyogo Prefectural Cancer Registry); K Kurosawa, Y Nemoto (Ibaraki Prefectural Cancer Registry); H Narimatsu, M Sakaguchi (Kanagawa Cancer Registry); S Kanemura (Miyagi Prefectural Cancer Registry); M Naito, R Narisawa (Niigata Prefecture Cancer Registry); I Miyashiro, K Nakata (Osaka Cancer Registry); D Mori, M Yoshitake (Saga Prefectural Cancer Registry); I Oki (Tochigi Prefectural Cancer Registry); N Fukushima, A Shibata (Yamagata Prefectural Cancer Registry); K Iwasa, C Ono (Yamanashi Cancer Registry); T Matsuda* (National Cancer Center); Jordan: O Nimri (Jordan National Cancer Registry); South Korea: KW Jung, YJ Won (Korea Central Cancer Registry); Kuwait: E Alawadhi, A Elbasmi (Kuwait Cancer Registry); Malaysia: A Ab Manan (Malaysia National Cancer Registry); F Adam (Penang Cancer Registry); Mongolia: E Nansalmaa, U Tudev (Cancer Registry of Mongolia); C Ochir (Mongolian National University of Medical Sciences); Qatar: AM Al Khafer, MM El Mistiri (Qatar Cancer Registry); Singapore: GH Lim, YY Teo (Singapore Cancer Registry); Taiwan: CJ Chiang, WC Lee (Taiwan Cancer Registry); Thailand: R Buasom, S Sangrajrang (Bangkok Cancer Registry); K Suwanrungruang, P Vatanasapt (Khon Kaen Provincial Cancer Registry); K Daoprasert, D Pongnikorn (Lampang Cancer Registry); Lamphun Cancer Registry); A Leklob, S Sangkitipaiboon (Lopburi Cancer Registry); SL Geater, H Sriplung (Songkhla Cancer Registry); Turkey: O Ceylan, I Kög (Ankara Cancer Registry); O Dirican (Antalya Cancer Registry); T Köse (Bursa Cancer Registry); T Gurbuz (Edirne Cancer Registry); FE Karaşahin, D Turhan (Erzurum Cancer Registry Center); U Aktaş, H Halat (Eskişehir Cancer Registry); S Eser, CI Yakut (Izmir

Cancer Registry); M Altinisik, Y Cavusoglu (Samsun Cancer Registry); A Türkköylü, N Uçüncü (Trabzon Cancer Registry). Europe—Austria: M Hackl (Austrian National Cancer Registry); Belarus: AA Zborovskaya (Belarus Childhood Cancer Subregistry); OV Aleinikova (Belarusian Research Center for Pediatric Oncology, Hematology and Immunology); Belgium: K Henau, L Van Eycken (Belgian Cancer Registry); Bulgaria: TY Atanasov, Z Valerianova (Bulgarian National Cancer Registry); Croatia: M Šekerića (Croatian National Cancer Registry); Czech Republic: L Dušek, M Zvolský (Czech National Cancer Registry); Denmark: L Steinrud Mørch, H Storm*, C Wessel Skovlund (Danish Cancer Society); Estonia: K Innos, M Mägi (Estonian Cancer Registry); Finland: N Malila, K Seppä (Cancer Society of Finland); France: J Jégu, M Velten (Bas-Rhin General Cancer Registry); E Cornet, X Troussard (Registre Régional des Hémopathies Malignes de Basse Normandie); AM Bouvier (Registre Bourguignon des Cancers Digestifs); AV Guizard (Registre Général des Tumeurs du Calvados); V Bouvier, G Launoy (Registre des Tumeurs Digestives du Calvados); S Dabakuyo Yonli, M Loillot (Breast and Gynecologic Cancer Registry of Côte d'Or France); M Maynadié, M Mounier (Hémopathies Malignes de Côte d'Or); L Vaconnet, AS Woronoff (Doubs General Cancer Registry); M Daoulas, M Robaszkiewicz (Finistère Cancer Registry); J Clavel, C Poulalhon (French National Registry of Childhood Hematopoietic Malignancies); E Desandes, B Lacour (National Registry of Childhood Solid Tumors); I Baldi, C Pouchieu (Gironde Registry of Primary Central Nervous System Tumors); B Amadeo, G Coureau (General Cancer Registry of Gironde Department); A Monnereau, S Orazio (Registre des Hémopathies Malignes de la Gironde); M Audoin, TC D'Almeida (Registre Général des Cancers de Haute-Vienne); S Boyer, K Hammas (Haut-Rhin Cancer Registry); B Trétarre (Registre des Tumeurs de l'Hérault); M Colonna, P Delafosse (Registre du Cancer du Département de l'Işère); S Plouvier (Registre Général des Cancers de Lille et de sa Région); A Cowppli-Bony (Loire-Atlantique-Vendée Cancer Registry); F Molinié (Loire-Atlantique-Vendée Cancer Registry; French Network of Cancer Registries (FRANCIM)); S Bara (Manche Cancer Registry); O Gantry, B Lapôtre-Ledoux (Registre du Cancer de la Somme); L Daubisse-Marliac (Tarn Cancer Registry); N Bossard, Z Uhry (Hospices Civils de Lyon); J Estève† (Université Claude Bernard, Lyon); Germany: R Stabenow, H Wilsdorf-Köhler (Common Cancer Registry of the Federal States); A Eberle, S Luttmann (Bremen Cancer Registry); I Löhden, AL Nennecke (Hamburg Cancer Registry); J Kieschke, E Sirri (Epidemiological Cancer Registry of Lower Saxony); C Justenhoven, SR Zeissig (Rhineland Palatinate Cancer Registry); B Holleczek (Saarland Cancer Registry); N Eisemann, A Katalinic (Schleswig-Holstein Cancer Registry); Gibraltar: RA Asquez, V Kumar (Gibraltar Cancer Registry); Greece: E Petridou (Nationwide Registry for Childhood Haematological Malignancies and Solid Tumors); Iceland: EJ Ólafsdóttir, L Tryggvadóttir (Icelandic Cancer Registry, Icelandic Cancer Society); Ireland: DE Murray, PM Walsh (National Cancer Registry Ireland); H Sundseth* (European Institute of Women's Health); Italy: G Mazzoleni, F Vittadello (Registro Tumori Alto Adige); E Coviello, F Cuccaro (Registro Tumori Puglia – Sezione ASL BT); R Galasso (Registro Tumori di Basilicata); G Sampietro (Registro Tumori di Bergamo); A Giacomin† (Piedmont Cancer Registry Provinces of Biella and Vercelli); M Magoni (Registro Tumori Dell'ASL Di Brescia); A Ardizzone (Registro Tumori Brindisi); A D'Argenzo (Caserta Cancer Registry); AA Di Prima, A Ippolito (Integrated Cancer Registry of Catania-Messina-Siracusa-Enna); AM Lavecchia, A Sutera Sardo (Registro Tumori Catanzaro); G Gola (Registro Tumori della Provincia di Como); P Ballotari, E Giacomazzi (Registro Tumori Cremona; Registro Tumori Mantova); S Ferretti (Registro Tumori della Provincia di Ferrara); L Dal Maso, D Serraino (Registro Tumori del Friuli Venezia Giulia); MV Celesia, RA Filiberti (Registro Tumori Regione Liguria); F Pannozzo (Registro Tumori della Provincia di Latina); A Melcarne, F Quarta (Registro Tumori Della Provincia Di Lecce Sezione RTP); A Andreo, AG Russo (Registro Tumori Milano); G Carrozzi, C Cirilli (Registro Tumori della Provincia di Modena); L Cavalieri d'Oro, M Rognoni (Registro Tumori di Monza e Brianza); M Fusco, MF Vitale (Registro Tumori della ASL Napoli 3 Sud); M Usala (Nuoro Cancer Registry); R Cusimano, W Mazzucco (Registro Tumori di Palermo e Provincia); M Michiara, P Sgarbi (Registro Tumori della Provincia di Parma); L Boschetti (Cancer Registry of the province of Pavia); G Chiaranda, M Seghini (Registro Tumori Piacenza); MM Maule, F Merletti (Piedmont
C Wiggins (New Mexico Tumor Registry); AR Kahn, MJ Schymura (New York State Cancer Registry); S Radhakrishnan, C Rao (North Carolina Central Cancer Registry); LK Giljahn, RM Slocumb (Ohio Cancer Incidence Surveillance System); C Dabbs, RE Espinoza (Oklahoma Central Cancer Registry); KG Aird, T Beran (Oregon State Cancer Registry); JJ Rubertone, SJ Slack (Pennsylvania Cancer Registry); J Oh (Rhode Island Cancer Registry); TA Janes, SM Schwartz (Seattle Cancer Surveillance System); SC Chiodini, DM Hurley (South Carolina Central Cancer Registry); MA Whiteside (Tennessee Cancer Registry); S Rai, MA Williams (Texas Cancer Registry); K Herget, C Sweeney (Utah Cancer Registry); AT Johnson (Vermont Cancer Registry); MB Keitheri Cheteri, P Migliore Santiago (Washington State Cancer Registry); SE Blankenship, S Farley (West Virginia Cancer Registry); R Borchers, R Malicki (Wisconsin Department of Health Services); J Espinoza, J Grandpre (Wyoming Cancer Surveillance Program); HK Weir*, R Wilson (Centers for Disease Control and Prevention); BK Edwards*, A Mariotto (National Cancer Institute). Asia—China: N Wang, L Yang (Beijing Cancer Registry); JS Chen, Y Zhou (Changle City Cancer Registry); YT He, GH Song (Cixian Cancer Registry); XP Gu (Dafeng County Center for Disease Control and Prevention); D Mei, HJ Mu (Dalian Centers for Disease Prevention and Control); HM Ge, TH Wu (Donghai County Center for Disease Prevention and Control); YY Li, DL Zhao (Feicheng County Cancer Registry); F Jin, JH Zhang (Ganyu Center for Disease Prevention and Control); FD Zhu (Guanyun Cancer Registry); Q Junhua, YL Yang (Haimen Cancer Registry); CX Jiang (Haining City Cancer Registry); W Biao, J Wang (Jianhu Cancer Registry); QL Li (Jiashan County Cancer Registry); H Yi, X Zhou (Jintan Cancer Registry); J Dong, W Li (Lianyungang Center for Disease Prevention and Control); FX Fu, SZ Liu (Linzhou Cancer Registry); JG Chen, J Zhu (Qidong County Cancer Registry); YH Li, YQ Lu (Sihui Cancer Registry); M Fan, SQ Huang (Taixing Cancer Registry); GP Guo, H Zhaolai (Cancer Institute of Yangzhong City); K Wei (Zhongshan City Cancer Registry); WQ Chen*, W Wei*, H Zeng (The National Cancer Center); *Cyprus: AV Demetriou (Cyprus Cancer Registry); Hong Kong: WK Mang, KC Ngan (Hong Kong Cancer Registry); India: AC Kataki, M Krishnatreya (Guwahati Cancer Registry); PA Jayalekshmi, P Sebastian (Karunagappally Cancer Registry); PS George, A Mathew (Trivandrum Cancer Registry); A Nandakumar* (National Centre for Disease Informatics and Research); Iran: R Malekzadeh, G Roshandel (Golestan Population-based Cancer Registry); Israel: L Keinan-Boker, BG Silverman (Israel National Cancer Registry); Japan: H Ito, Y Koyanagi (Aichi Cancer Registry); M Sato, F Tobori (Akita Prefectural Cancer Registry); I Nakata, N Teramoto (Ehime Prefectural Cancer Registry); M Hattori, Y Kaizai (Fukui Cancer Registry); F Moki (Gunma Prefectural Cancer Registry); H Sugiyama, M Utada (Hiroshima Prefecture Cancer Registry); M Nishimura, K Yoshida (Hyogo Prefectural Cancer Registry); K Kurosawa, Y Nemoto (Ibaraki Prefectural Cancer Registry); H Narimatsu, M Sakaguchi (Kanagawa Cancer Registry); S Kanemura (Miyagi Prefectural Cancer Registry); M Naito, R Narisawa (Niigata Prefecture Cancer Registry); I Miyashiro, K Nakata (Osaka Cancer Registry); D Mori, M Yoshitake (Saga Prefectural Cancer Registry); I Oki (Tochigi Prefectural Cancer Registry); N Fukushima, A Shibata (Yamagata Prefectural Cancer Registry); K Iwasa, C Ono (Yamanashi Cancer Registry); T Matsuda* (National Cancer Center); Jordan: O Nimri (Jordan National Cancer Registry); South Korea: KW Jung, YJ Won (Korea Central Cancer Registry); Kuwait: E Alawadhi, A Elbasmi (Kuwait Cancer Registry); Malaysia: A Ab Manan (Malaysia National Cancer Registry); F Adam (Penang Cancer Registry); Mongolia: E Nansalmaa, U Tudev (Cancer Registry of Mongolia); C Ochir (Mongolian National University of Medical Sciences); Qatar: AM Al Khafer, MM El Mistiri (Qatar Cancer Registry); Singapore: GH Lim, YY Teo (Singapore Cancer Registry); Taiwan: CJ Chiang, WC Lee (Taiwan Cancer Registry); Thailand: R Buasom, S Sangrajrang (Bangkok Cancer Registry); K Suwanrungruang, P Vatanasapt (Khon Kaen Provincial Cancer Registry); K Daoprasert, D Pongnikorn (Lampang Cancer Registry); Lamphun Cancer Registry); A Leklob, S Sangkitipaiboon (Lopburi Cancer Registry); SL Geater, H Sriplung (Songkhla Cancer Registry); Turkey: O Ceylan, I Kög (Ankara Cancer Registry); O Dirican (Antalya Cancer Registry); T Köse (Bursa Cancer Registry); T Gurbuz (Edirne Cancer Registry); FE Karaşahin, D Turhan (Erzurum Cancer Registry Center); U Aktaş, Y Halat (Eskişehir Cancer Registry); S Eser, CI Yakut (Izmir

Cancer Registry); M Altinisik, Y Cavusoglu (Samsun Cancer Registry); A Türkköylü, N Uçüncü (Trabzon Cancer Registry). Europe—Austria: M Hackl (Austrian National Cancer Registry); Belarus: AA Zborovskaya (Belarus Childhood Cancer Subregistry); OV Aleinikova (Belarusian Research Center for Pediatric Oncology, Hematology and Immunology); Belgium: K Henau, L Van Eycken (Belgian Cancer Registry); Bulgaria: TY Atanasov, Z Valerianova (Bulgarian National Cancer Registry); Croatia: M Šekerića (Croatian National Cancer Registry); Czech Republic: L Dušek, M Zvolský (Czech National Cancer Registry); Denmark: L Steinrud Mørch, H Storm*, C Wessel Skovlund (Danish Cancer Society); Estonia: K Innos, M Mägi (Estonian Cancer Registry); Finland: N Malila, K Seppä (Cancer Society of Finland); France: J Jégu, M Velten (Bas-Rhin General Cancer Registry); E Cornet, X Troussard (Registre Régional des Hémopathies Malignes de Basse Normandie); AM Bouvier (Registre Bourguignon des Cancers Digestifs); AV Guizard (Registre Général des Tumeurs du Calvados); V Bouvier, G Launoy (Registre des Tumeurs Digestives du Calvados); S Dabakuyo Yonli, M Loillot (Breast and Gynecologic Cancer Registry of Côte d'Or France); M Maynadié, M Mounier (Hémopathies Malignes de Côte d'Or); L Vaconnet, AS Woronoff (Doubs General Cancer Registry); M Daoulas, M Robaszkiewicz (Finistère Cancer Registry); J Clavel, C Poulalhon (French National Registry of Childhood Hematopoietic Malignancies); E Desandes, B Lacour (National Registry of Childhood Solid Tumors); I Baldi, C Pouchieu (Gironde Registry of Primary Central Nervous System Tumors); B Amadeo, G Coureau (General Cancer Registry of Gironde Department); A Monnereau, S Orazio (Registre des Hémopathies Malignes de la Gironde); M Audoin, TC D'Almeida (Registre Général des Cancers de Haute-Vienne); S Boyer, K Hammas (Haut-Rhin Cancer Registry); B Trétarre (Registre des Tumeurs de l'Hérault); M Colonna, P Delafosse (Registre du Cancer du Département de l'Işère); S Plouvier (Registre Général des Cancers de Lille et de sa Région); A Cowppli-Bony (Loire-Atlantique-Vendée Cancer Registry); F Molinié (Loire-Atlantique-Vendée Cancer Registry; French Network of Cancer Registries (FRANCIM)); S Bara (Manche Cancer Registry); O Gantry, B Lapôtre-Ledoux (Registre du Cancer de la Somme); L Daubisse-Marliac (Tarn Cancer Registry); N Bossard, Z Uhry (Hospices Civils de Lyon); J Estève† (Université Claude Bernard, Lyon); Germany: R Stabenow, H Wilsdorf-Köhler (Common Cancer Registry of the Federal States); A Eberle, S Luttmann (Bremen Cancer Registry); I Löhden, AL Nennecke (Hamburg Cancer Registry); J Kieschke, E Sirri (Epidemiological Cancer Registry of Lower Saxony); C Justenhoven, SR Zeissig (Rhineland Palatinate Cancer Registry); B Holleczek (Saarland Cancer Registry); N Eisemann, A Katalinic (Schleswig-Holstein Cancer Registry); Gibraltar: RA Asquez, V Kumar (Gibraltar Cancer Registry); Greece: E Petridou (Nationwide Registry for Childhood Haematological Malignancies and Solid Tumors); Iceland: EJ Ólafsdóttir, L Tryggvadóttir (Icelandic Cancer Registry, Icelandic Cancer Society); Ireland: DE Murray, PM Walsh (National Cancer Registry Ireland); H Sundseth* (European Institute of Women's Health); Italy: G Mazzoleni, F Vittadello (Registro Tumori Alto Adige); E Coviello, F Cuccaro (Registro Tumori Puglia – Sezione ASL BT); R Galasso (Registro Tumori di Basilicata); G Sampietro (Registro Tumori di Bergamo); A Giacomin† (Piedmont Cancer Registry Provinces of Biella and Vercelli); M Magoni (Registro Tumori Dell'ASL Di Brescia); A Ardizzone (Registro Tumori Brindisi); A D'Argenzo (Caserta Cancer Registry); AA Di Prima, A Ippolito (Integrated Cancer Registry of Catania-Messina-Siracusa-Enna); AM Lavecchia, A Sutera Sardo (Registro Tumori Catanzaro); G Gola (Registro Tumori della Provincia di Como); P Ballotari, E Giacomazzi (Registro Tumori Cremona; Registro Tumori Mantova); S Ferretti (Registro Tumori della Provincia di Ferrara); L Dal Maso, D Serraino (Registro Tumori del Friuli Venezia Giulia); MV Celesia, RA Filiberti (Registro Tumori Regione Liguria); F Pannozzo (Registro Tumori della Provincia di Latina); A Melcarne, F Quarta (Registro Tumori Della Provincia Di Lecce Sezione RTP); A Andreo, AG Russo (Registro Tumori Milano); G Carrozzi, C Cirilli (Registro Tumori della Provincia di Modena); L Cavalieri d'Oro, M Rognoni (Registro Tumori di Monza e Brianza); M Fusco, MF Vitale (Registro Tumori della ASL Napoli 3 Sud); M Usala (Nuoro Cancer Registry); R Cusimano, W Mazzucco (Registro Tumori di Palermo e Provincia); M Michiara, P Sgarbi (Registro Tumori della Provincia di Parma); L Boschetti (Cancer Registry of the province of Pavia); G Chiaranda, M Seghini (Registro Tumori Piacenza); MM Maule, F Merletti (Piedmont
Childhood Cancer Registry); E Spata, R Tumino (Registro Tumori della Provincia di Ragusa); P Mancuso (Registro Tumori Reggio Emilia); T Cassetti, R Sassatelli (Pancreas Tumor Registry of Reggio Emilia); F Falcini, S Giorgetti (Registro Tumori della Romagna); AL Caiazzo, R Cavallo (Registro Tumori Salerno); D Piras (Registro Tumori Nord Sardegna); F Bella, A Madeddu (Registro Tumori Siracusa); AC Fanetti, S Maspero (Registro Tumori della Provincia di Sondrio); S Carone, A Mincuzzi (Registro Tumori Taranto); G Candela, T Scuderi (Registro Tumori Trapani); MA Gentilini, R Rizzello (Registro Tumori Trento); S Rosso (Piedmont Cancer Registry); A Caldarella, T Intrieri (Registro Tumori della Regione Toscana); F Bianconi (Registro Tumori Umbro di Popolazione); P Contiero, G Tagliabue (Registro Tumori Lombardia, Provincia di Varese); M Rugge, M Zorzi (Registro Tumori Veneto); S Beggiato, A Brustolin (Registro Tumori Della Provincia Di Viterbo); G Gatta (Fondazione IRCCS Istituto Nazionale dei Tumori); R De Angelis (National Centre for Epidemiology); M Vicentini (Italian Association of Cancer Registries (AIRTUM)); Registro Tumori Reggio Emilia); R Zanetti* (International Association of Cancer Registries; Piedmont Cancer Registry); F Stracci (Italian Association of Cancer Registries (AIRTUM)); Registro Tumori Umbro di Popolazione); Latvia: A Maurina, M Oniščuka (Latvian Cancer Registry); Liechtenstein: M Mousavi (Liechtenstein); Lithuania: N Lipunova, I Vincerževskienė (Lithuanian Cancer Registry); Malta: D Agius, N Calleja (Malta National Cancer Registry); Netherlands: S Siesling, O Visser (Netherlands Cancer Registry, IKNL); Norway: TB Johannesen, S Læronningen (The Cancer Registry of Norway); Poland: M Trojanowski (Wielkopolski Rejestr Nowotworów); P Macek (Świętokrzyski Rejestr Nowotworów); T Mierzwa (Kujawsko-Pomorski Rejestr Nowotworów); J Rachtan (Malopolski Rejestr Nowotworów); A Rosińska (Lódzki Rejestr Nowotworów); K Kępska (Dolnośląski Rejestr Nowotworów); B Kościańska (Lubelski Rejestr Nowotworów); K Barna (Lubuski Rejestr Nowotworów); U Sulkowska (Mazowiecki Rejestr Nowotworów); T Gebauer (Opolski Rejestr Nowotworów); J Łapińska (Podlaski Rejestr Nowotworów); J Wójcik-Tomaszewska (Pomorski Rejestr Nowotworów); M Motnyk (Śląski Rejestr Nowotworów); A Patro (Podkarparcki Rejestr Nowotworów); A Gos (Warmińsko-Mazurski Rejestr Nowotworów); K Sikorska (Zachodniopomorski Rejestr Nowotworów); M Bielska-Lasota (National Institute of Public Health, NIH); JA Didkowska, U Wojciechowska (Polish National Cancer Registry); Portugal: G Forjaz de Lacerda, RA Rego (Registo Oncológico Regional dos Açores); B Carrito, A Pais (Registro Oncológico Regional do Centro); MJ Bento, J Rodrigues (Registro Oncológico Regional do Norte); A Lourenço, A Mayer-da-Silva (Registro Oncológico Regional do Sul); Romania: LM Blaga, D Coza (Cancer Institute I. Chiricuta); Russia: MY Valkov (Arkhangelsk Regional Cancer Registry); L Gusenkova, O Lazarevich (Population Cancer Registry of the Republic of Karelia); O Prudnikova, DM Vjushkov (Omsk Regional Cancer Registry); A Egorova, A Orlov (Samara Cancer Regional Registry); LV Pikalova, LD Zhuikova (Population-Based Cancer Registry of Tomsk); Slovakia: J Adamcik, C Safaei Diba (National Cancer Registry of Slovakia); Slovenia: V Zadnik, T Žagar (Cancer Registry of Republic of Slovenia); Spain: M De-La-Cruz, A Lopez-de-Munain (Basque Country Cancer Registry); A Aleman, D Rojas (Registro Poblacional de Cáncer de la Comunidad Autónoma de Canarias); RJ Chillarón, AIM Navarro (Registro de Cáncer de Cuenca); R Marcos-Gragera, M Puigdemont (Girona Cancer Registry); M Rodríguez-Barranco, MJ Sánchez Perez (Granada Cancer Registry); P Franch Sureda, M Ramos Montserrat (Mallorca Cancer Registry); MD Chirlaque López, A Sánchez Gil (Murcia Cancer Registry); E Ardanaz, M Guevara (Registro de Cáncer de Navarra, CIBERESP); A Cañete-Nieto, R Peris-Bonet (RETI-SEHOP, Universidad de Valencia); M Carulla, J Galceran (Tarragona Cancer Registry); F Almela, C Sabater (Comunitat Valenciana Childhood Cancer Registry); Sweden: S Khan, D Pettersson (Swedish Cancer Registry); P Dickman* (Karolinska Institutet, Stockholm); Switzerland: K Staehelin, B Struchen (Basel Cancer Registry); C Herrmann (East Switzerland Cancer Registry); C Egger Hayoz (Registre Fribourgeois des Tumeurs); C Bouchardy, R Schaffar (Geneva Cancer Registry); P Went (Cancer Registry Graubünden-Glarus); SM Mousavi (Cancer Registry Graubünden-Glarus; East Switzerland Cancer Registry); JL Bulliard, M Maspoli-Conconi (Registre Neuchâtelois et Jurassien des Tumeurs); CE Kuehni, SM Redmond (Childhood Cancer Registry); A Bordoni, L Ortelli (Registro Tumori Canton Ticino); A Chiolero, I Konzelmann (Registre Valaisan des

Tumeurs); S Rohrmann, M Wanner (Cancer Registry Zürich and Zug); UK: J Broggio, J Rashbass, C Stiller* (National Cancer Registration and Analysis Service England); D Fitzpatrick, A Gavin (Northern Ireland Cancer Registry); DS Morrison, CS Thomson (Scottish Cancer Registry); G Greene, DW Huws (Welsh Cancer Intelligence & Surveillance Unit); C Allemani*, MP Coleman*, V Di Carlo, F Girardi, M Matz, P Minicozzi, N Sanz, N Ssenyonga (London School of Hygiene & Tropical Medicine); R Stephens* (Patient Advocate, Stevenage). Oceania—Australia: E Chalker, M Smith (Australian Capital Territory Cancer Registry); J Gugusheff, H You (NSW Cancer Registry); S Qin Li, S Dugdale (Northern Territory of Australia Cancer Registry); J Moore, S Philpot (Queensland Cancer Registry); R Pfeiffer, H Thomas (South Australian Cancer Registry); B Silva Ragaini, AJ Venn (Tasmanian Cancer Registry); SM Evans, L Te Marvelde (Victorian Cancer Registry); V Savietto, R Trevithick (Western Australian Cancer Registry); D Currow* (Cancer Institute NSW); New Zealand: C Fowler, C Lewis (New Zealand Cancer Registry).

*CONCORD Steering Committee.

†Prof Estève passed away in February, 2022.

### Contributors

CA, MPC, and NS contributed to study design. MPC and CA contributed to acquisition of statutory and ethical approvals. VDC, CA, and MPC contributed to construction of life tables. NS, VDC, CA, and MPC contributed to data quality control and had full access to all the data in the study. NS did the formal analyses. NS, CA, and MPC were responsible for writing the original draft. CS, KN, JS, SR, and FG contributed to review and editing, and provided advice on methods and interpretation of results. All authors checked and contributed to writing the final report. All CONCORD Working Group members had access to the results of all steps of data preparation, quality control, and analyses, and contributed to interpretation of the findings. CA was responsible for acquisition of funding.

### Declaration of interests

DWH received a grant for joint co-production of cancer intelligence analysis outputs from Macmillan Cancer Support, consultancy fees from Pfizer for research carried out by Swansea University, Wales, UK, in relation to value-based health care, and unsolicited small gifts from Moondance Cancer Initiative for philanthropic work. All other authors declare no competing interests.

### Data sharing

This publication contains the results of secondary analysis of sensitive personal data, carried out with approval from the UK's statutory Health Research Authority and from the NHS Research Ethics Service. The individual records for CONCORD-3 were provided by more than 300 population-based cancer registries in more than 70 countries. We hold these data in trust from each participating registry to perform only the analyses agreed in the protocol, which prohibits sharing of the raw data without express approval from the participating registries.

### Acknowledgments

This study was funded by Children with Cancer UK, the Institut National du Cancer, La Ligue Contre le Cancer, the US Centers for Disease Control and Prevention, Swiss Re, Swiss Cancer Research foundation, Swiss Cancer League, Rossy Family Foundation, the US National Cancer Institute, and the American Cancer Society. The interpretation of the findings in this report, and the opinions, conclusions, and recommendations are those of the authors and do not necessarily reflect the views or official position of the British Columbia Cancer Agency or Cancer Care Ontario (Canada); the Centers for Disease Control and Prevention (USA), the National Cancer Institute (USA), the Maryland Cancer Registry (USA), the New Hampshire Department of Health and Human Services (USA), the New York City Department of Health and Mental Hygiene (USA), the Ohio Department of Health (USA), the Pennsylvania Department of Health or West Virginia Cancer Registry (USA), the Health Directorate of the Australian Capital Territory, or the Institut National du Cancer (France). We thank Keiu Paapsi (Estonia Cancer registry) for her thoughtful comments and Tahera Razavi for preliminary data management.

Editorial note: the Lancet Group takes a neutral position with respect to territorial claims in published maps and institutional affiliations.
Childhood Cancer Registry); E Spata, R Tumino (Registro Tumori della Provincia di Ragusa); P Mancuso (Registro Tumori Reggio Emilia); T Cassetti, R Sassatelli (Pancreas Tumor Registry of Reggio Emilia); F Falcini, S Giorgetti (Registro Tumori della Romagna); AL Caiazzo, R Cavallo (Registro Tumori Salerno); D Piras (Registro Tumori Nord Sardegna); F Bella, A Madeddu (Registro Tumori Siracusa); AC Fanetti, S Maspero (Registro Tumori della Provincia di Sondrio); S Carone, A Mincuzzi (Registro Tumori Taranto); G Candela, T Scuderi (Registro Tumori Trapani); MA Gentilini, R Rizzello (Registro Tumori Trento); S Rosso (Piedmont Cancer Registry); A Caldarella, T Intrieri (Registro Tumori della Regione Toscana); F Bianconi (Registro Tumori Umbro di Popolazione); P Contiero, G Tagliabue (Registro Tumori Lombardia, Provincia di Varese); M Rugge, M Zorzi (Registro Tumori Veneto); S Beggiato, A Brustolin (Registro Tumori Della Provincia Di Viterbo); G Gatta (Fondazione IRCCS Istituto Nazionale dei Tumori); R De Angelis (National Centre for Epidemiology); M Vicentini (Italian Association of Cancer Registries (AIRTUM)); Registro Tumori Reggio Emilia); R Zanetti* (International Association of Cancer Registries; Piedmont Cancer Registry); F Stracci (Italian Association of Cancer Registries (AIRTUM)); Registro Tumori Umbro di Popolazione); Latvia: A Maurina, M Oniščuka (Latvian Cancer Registry); Liechtenstein: M Mousavi (Liechtenstein); Lithuania: N Lipunova, I Vincerževskienė (Lithuanian Cancer Registry); Malta: D Agius, N Calleja (Malta National Cancer Registry); Netherlands: S Siesling, O Visser (Netherlands Cancer Registry, IKNL); Norway: TB Johannesen, S Lørenningen (The Cancer Registry of Norway); Poland: M Trojanowski (Wielkopolski Rejestr Nowotworów); P Macek (Świętokrzyski Rejestr Nowotworów); T Mierzwa (Kujawsko-Pomorski Rejestr Nowotworów); J Rachtan (Malopolski Rejestr Nowotworów); A Rosińska (Lódzki Rejestr Nowotworów); K Kępska (Dolnośląski Rejestr Nowotworów); B Kościańska (Lubelski Rejestr Nowotworów); K Barna (Lubuski Rejestr Nowotworów); U Sulkowska (Mazowiecki Rejestr Nowotworów); T Gebauer (Opolski Rejestr Nowotworów); J Łapińska (Podlaski Rejestr Nowotworów); J Wójcik-Tomaszewska (Pomorski Rejestr Nowotworów); M Motnyk (Śląski Rejestr Nowotworów); A Patro (Podkarparcki Rejestr Nowotworów); A Gos (Warmińsko-Mazurski Rejestr Nowotworów); K Sikorska (Zachodniopomorski Rejestr Nowotworów); M Bielska-Lasota (National Institute of Public Health, NIH); JA Didkowska, U Wojciechowska (Polish National Cancer Registry); Portugal: G Forjaz de Lacerda, RA Rego (Registo Oncológico Regional dos Açores); B Carrito, A Pais (Registro Oncológico Regional do Centro); MJ Bento, J Rodrigues (Registro Oncológico Regional do Norte); A Lourenço, A Mayer-da-Silva (Registro Oncológico Regional do Sul); Romania: LM Blaga, D Coza (Cancer Institute I. Chiricuta); Russia: MY Valkov (Arkhangelsk Regional Cancer Registry); L Gusenkova, O Lazarevich (Population Cancer Registry of the Republic of Karelia); O Prudnikova, DM Vjushkov (Omsk Regional Cancer Registry); A Egorova, A Orlov (Samara Cancer Regional Registry); LV Pikalova, LD Zhuikova (Population-Based Cancer Registry of Tomsk); Slovakia: J Adamcik, C Safaei Diba (National Cancer Registry of Slovakia); Slovenia: V Zadnik, T Žagar (Cancer Registry of Republic of Slovenia); Spain: M De-La-Cruz, A Lopez-de-Munain (Basque Country Cancer Registry); A Aleman, D Rojas (Registro Poblacional de Cáncer de la Comunidad Autónoma de Canarias); RJ Chillarón, AIM Navarro (Registro de Cáncer de Cuenca); R Marcos-Gragera, M Puigdemont (Girona Cancer Registry); M Rodríguez-Barranco, MJ Sánchez Perez (Granada Cancer Registry); P Franch Sureda, M Ramos Montserrat (Mallorca Cancer Registry); MD Chirlaque López, A Sánchez Gil (Murcia Cancer Registry); E Ardanaz, M Guevara (Registro de Cáncer de Navarra, CIBERESP); A Cañete-Nieto, R Peris-Bonet (RETI-SEHOP, Universidad de Valencia); M Carulla, J Galceran (Tarragona Cancer Registry); F Almela, C Sabater (Comunitat Valenciana Childhood Cancer Registry); Sweden: S Khan, D Pettersson (Swedish Cancer Registry); P Dickman* (Karolinska Institutet, Stockholm); Switzerland: K Staehelin, B Struchen (Basel Cancer Registry); C Herrmann (East Switzerland Cancer Registry); C Egger Hayoz (Registre Fribourgeois des Tumeurs); C Bouchardy, R Schaffar (Geneva Cancer Registry); P Went (Cancer Registry Graubünden-Glarus); SM Mousavi (Cancer Registry Graubünden-Glarus; East Switzerland Cancer Registry); JL Bulliard, M Maspoli-Conconi (Registre Neuchâtelois et Jurassien des Tumeurs); CE Kuehni, SM Redmond (Childhood Cancer Registry); A Bordoni, L Ortelli (Registro Tumori Canton Ticino); A Chiolero, I Konzelmann (Registre Valaisan des

Tumeurs); S Rohrmann, M Wanner (Cancer Registry Zürich and Zug); UK: J Broggio, J Rashbass, C Stiller* (National Cancer Registration and Analysis Service England); D Fitzpatrick, A Gavin (Northern Ireland Cancer Registry); DS Morrison, CS Thomson (Scottish Cancer Registry); G Greene, DW Huws (Welsh Cancer Intelligence & Surveillance Unit); C Allemani*, MP Coleman*, V Di Carlo, F Girardi, M Matz, P Minicozzi, N Sanz, N Ssenyonga (London School of Hygiene & Tropical Medicine); R Stephens* (Patient Advocate, Stevenage). Oceania—Australia: E Chalker, M Smith (Australian Capital Territory Cancer Registry); J Gugusheff, H You (NSW Cancer Registry); S Qin Li, S Dugdale (Northern Territory of Australia Cancer Registry); J Moore, S Philpot (Queensland Cancer Registry); R Pfeiffer, H Thomas (South Australian Cancer Registry); B Silva Ragaini, AJ Venn (Tasmanian Cancer Registry); SM Evans, L Te Marvelde (Victorian Cancer Registry); V Savetto, R Trevithick (Western Australian Cancer Registry); D Currow* (Cancer Institute NSW); New Zealand: C Fowler, C Lewis (New Zealand Cancer Registry).

*CONCORD Steering Committee.

†Prof Estève passed away in February, 2022.

### Contributors

CA, MPC, and NS contributed to study design. MPC and CA contributed to acquisition of statutory and ethical approvals. VDC, CA, and MPC contributed to construction of life tables. NS, VDC, CA, and MPC contributed to data quality control and had full access to all the data in the study. NS did the formal analyses. NS, CA, and MPC were responsible for writing the original draft. CS, KN, JS, SR, and FG contributed to review and editing, and provided advice on methods and interpretation of results. All authors checked and contributed to writing the final report. All CONCORD Working Group members had access to the results of all steps of data preparation, quality control, and analyses, and contributed to interpretation of the findings. CA was responsible for acquisition of funding.

### Declaration of interests

DWH received a grant for joint co-production of cancer intelligence analysis outputs from Macmillan Cancer Support, consultancy fees from Pfizer for research carried out by Swansea University, Wales, UK, in relation to value-based health care, and unsolicited small gifts from Moondance Cancer Initiative for philanthropic work. All other authors declare no competing interests.

### Data sharing

This publication contains the results of secondary analysis of sensitive personal data, carried out with approval from the UK's statutory Health Research Authority and from the NHS Research Ethics Service. The individual records for CONCORD-3 were provided by more than 300 population-based cancer registries in more than 70 countries. We hold these data in trust from each participating registry to perform only the analyses agreed in the protocol, which prohibits sharing of the raw data without express approval from the participating registries.

### Acknowledgments

This study was funded by Children with Cancer UK, the Institut National du Cancer, La Ligue Contre le Cancer, the US Centers for Disease Control and Prevention, Swiss Re, Swiss Cancer Research foundation, Swiss Cancer League, Rossy Family Foundation, the US National Cancer Institute, and the American Cancer Society. The interpretation of the findings in this report, and the opinions, conclusions, and recommendations are those of the authors and do not necessarily reflect the views or official position of the British Columbia Cancer Agency or Cancer Care Ontario (Canada); the Centers for Disease Control and Prevention (USA), the National Cancer Institute (USA), the Maryland Cancer Registry (USA), the New Hampshire Department of Health and Human Services (USA), the New York City Department of Health and Mental Hygiene (USA), the Ohio Department of Health (USA), the Pennsylvania Department of Health or West Virginia Cancer Registry (USA), the Health Directorate of the Australian Capital Territory, or the Institut National du Cancer (France). We thank Keiu Paapsi (Estonia Cancer registry) for her thoughtful comments and Tahera Razavi for preliminary data management.

Editorial note: the Lancet Group takes a neutral position with respect to territorial claims in published maps and institutional affiliations.
References

1 Rodriguez-Abreu D, Bordoni A, Zucca E. Epidemiology of hematological malignancies. *Ann Oncol* 2007; **18** (suppl 1): i3–8.

2 Steliarova-Foucher E, Colombet M, Ries LAG, et al. International incidence of childhood cancer, 2001–10: a population-based registry study. *Lancet Oncol* 2017; **18**: 719–31.

3 Desandes E. Survival from adolescent cancer. *Cancer Treat Rev* 2007; **33**: 609–15.

4 Stark D, Bowen D, Dunwoodie E, et al. Survival patterns in teenagers and young adults with cancer in the United Kingdom: Comparisons with younger and older age groups. *Eur J Cancer* 2015; **51**: 2643–54.

5 Pritchard-Jones K, Kaatsch P, Steliarova-Foucher E, Stiller CA, Coebergh JW. Cancer in children and adolescents in Europe: developments over 20 years and future challenges. *Eur J Cancer* 2006; **42**: 2183–90.

6 Bleyer A. OLM, Barr R, Ries LAG. Cancer epidemiology in older adolescents and young adults 15 to 29 years of age, including SEER incidence and survival: 1975–2000. Bethesda, MD: National Cancer Institute, 2006.

7 Coebergh JW, Reedijk AM, de Vries E, et al. Leukaemia incidence and survival in children and adolescents in Europe during 1978–1997. Report from the Automated Childhood Cancer Information System project. *Eur J Cancer* 2006; **42**: 2019–36.

8 Trama A, Botta L, Foschi R, et al. Survival of European adolescents and young adults diagnosed with cancer in 2000–07: population-based data from EUROCARE-5. *Lancet Oncol* 2016; **17**: 896–906.

9 Allemani C, Matsuda T, Di Carlo V, et al. Global surveillance of trends in cancer survival 2000–14 (CONCORD-3): analysis of individual records for 37,513,025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. *Lancet* 2018; **391**: 1023–75.

10 Gatta G, Capocaccia R, De Angelis R, Stiller C, Coebergh JW. Cancer survival in European adolescents and young adults. *Eur J Cancer* 2003; **39**: 2600–10.

11 Gatta G, Corazziari I, Magnani C, Peris-Bonet R, Roazzi P, Stiller C. Childhood cancer survival in Europe. *Ann Oncol* 2003; **14** (suppl 5): v119–27.

12 Fritz AG, Percy C, Jack A, et al, eds. International Classification of Diseases for Oncology (ICD-O), 3rd edn. Geneva: World Health Organization, 2000.

13 Fritz AG, Percy C, Jack A, et al, eds. International Classification of Diseases for Oncology (ICD-O). First revision of 3rd edn. Geneva: World Health Organization, 2013.

14 Steliarova-Foucher E, Stiller C, Lacour B, Kaatsch P. International Classification of Childhood Cancer, third edition. *Cancer* 2005; **103**: 1457–67.

15 Perme MP, Stare J, Estève J. On estimation in relative survival. *Biometrics* 2012; **68**: 113–20.

16 Spika D, Bannon F, Bonaventure A, et al. Life tables for global surveillance of cancer survival (the CONCORD programme): data sources and methods. *BMC Cancer* 2017; **17**: 159–73.

17 Estève J, Benhamou E, Raymond L. Statistical methods in cancer research, volume IV. Descriptive epidemiology (IARC Scientific Publications No. 128). Lyon: International Agency for Research on Cancer, 1994.

18 Brenner H, Gefeller O. An alternative approach to monitoring cancer patient survival. *Cancer* 1996; **78**: 2004–10.

19 Stiller CA, Bunch KJ. Trends in survival for childhood cancer in Britain diagnosed 1971–85. *Br J Cancer* 1990; **62**: 806–15.

20 Trama A, Bernasconi A, McCabe MG, et al. Is the cancer survival improvement in European and American adolescent and young adults still lagging behind that in children? *Pediatr Blood Cancer* 2019; **66**: e27407.

21 Bonaventure A, Harewood R, Stiller CA, et al. Worldwide comparison of survival from childhood leukaemia for 1995–2009, by subtype, age, and sex (CONCORD-2): a population-based study of individual data for 89 828 children from 198 registries in 53 countries. *Lancet Haematol* 2017; **4**: e202–17.

22 Bartram J, Veys P, Vora A. Improvements in outcome of childhood acute lymphoblastic leukaemia (ALL) in the UK - a success story of modern medicine through successive UKALL trials and international collaboration. *Br J Haematol* 2020; **191**: 562–67.

23 De Angelis R, Minicozzi P, Sant M, et al. Survival variations by country and age for lymphoid and myeloid malignancies in Europe 2000–2007: Results of EUROCARE-5 population-based study. *Eur J Cancer* 2015; **51**: 2254–68.

24 Burnusuzov HA, Yordanova MN, Avramova BE, et al. Treatment of childhood acute myeloid leukemia in Bulgaria. *Folia Med* 2018; **60**: 234–40.

25 National Cancer Center. Cancer facts and figures 2015 in the Republic of Korea. Seoul: Ministry of Health and Welfare, 2015.

26 Zhou Q, Hong D, Lu J, Zheng D, Ashwani N, Hu S. Pediatric medical care system in China has significantly reduced abandonment of acute lymphoblastic leukemia treatment. *J Pediatr Hematol Oncol* 2015; **37**: 181–84.

27 Zeng H, Chen W, Zheng R, et al. Changing cancer survival in China during 2003–15: a pooled analysis of 17 population-based cancer registries. *Lancet Glob Health* 2018; **6**: e555–67.

28 Zeng H, Zheng R, Guo Y, et al. Cancer survival in China, 2003–2005: a population-based study. *Int J Cancer* 2015; **136**: 1921–30.

29 Bleyer A, Barr R, Hayes-Lattin B, Thomas D, Ellis C, Anderson B. The distinctive biology of cancer in adolescents and young adults. *Nat Rev Cancer* 2008; **8**: 288–98.

30 Siegel SE, Stock W, Johnson RH, et al. Pediatric-inspired treatment regimens for adolescents and young adults with Philadelphia chromosome-negative acute lymphoblastic leukemia: a review. *JAMA Oncol* 2018; **4**: 725–34.

31 Nakata K, Okawa S, Fuji S, et al. Trends in survival of leukemia among children, adolescents, and young adults: a population-based study in Osaka, Japan. *Cancer Sci* 2021; **112**: 1150–60.

32 Bleyer A. The adolescent and young adult gap in cancer care and outcome. *Curr Probl Pediatr Adolesc Health Care* 2005; **35**: 182–217.

33 Drozdov D, Bonaventure A, Nakata K, Suttorp M, Belot A. Temporal trends in the proportion of “cure” in children, adolescents, and young adults diagnosed with chronic myeloid leukemia in England: a population-based study. *Pediatr Blood Cancer* 2018; **65**: e27422.

34 Force LM, Abdollahpour I, Advani SM, et al. The global burden of childhood and adolescent cancer in 2017: an analysis of the Global Burden of Disease Study 2017. *Lancet Oncol* 2019; **20**: 1211–25.

35 WHO. WHO Global Initiative for Childhood Cancer: an overview. Geneva: World Health Organization, 2018.

36 Osborn MP, Johnson RH. Worldwide benefits of improving cancer care for adolescents and young adults in LMICs. *Lancet Oncol* 2020; **21**: 487–89.

37 Atun R, Bhakta N, Denburg A, et al. Sustainable care for children with cancer: a *Lancet Oncology* Commission. *Lancet Oncol* 2020; **21**: e185–224.

38 Bleyer A, Ferrari A, Whelan J, Barr RD. Global assessment of cancer incidence and survival in adolescents and young adults. *Pediatr Blood Cancer* 2017; **64**: e26497.

39 Coleman MP. Cancer survival: global surveillance will stimulate health policy and improve equity. *Lancet* 2014; **383**: 564–73.

40 Allemani C, Coleman MP. Public health surveillance of cancer survival in the United States and worldwide: The contribution of the CONCORD programme. *Cancer* 2017; **123** (suppl 24): 4977–81.

41 Corazziari I, Quinn M, Capocaccia R. Standard cancer patient population for age standardising survival ratios. *Eur J Cancer* 2004; **40**: 2307–16.

42 Miranda-Filho A, Bray F, Charvat H, Rajaraman S, Soerjomataram I. The world cancer patient population (WCPP): an updated standard for international comparisons of population-based survival. *Cancer Epidemiol* 2020; **69**: 101802.

43 Barr RD, Ries LAG, Trama A, et al. A system for classifying cancers diagnosed in adolescents and young adults. *Cancer* 2020; **126**: 4634–59.
## References

1. Rodriguez-Abreu D, Bordoni A, Zucca E. Epidemiology of hematological malignancies. *Ann Oncol* 2007; **18** (suppl 1): i3–8.

2. Steliarova-Foucher E, Colombet M, Ries LAG, et al. International incidence of childhood cancer, 2001–10: a population-based registry study. *Lancet Oncol* 2017; **18**: 719–31.

3. Desandes E. Survival from adolescent cancer. *Cancer Treat Rev* 2007; **33**: 609–15.

4. Stark D, Bowen D, Dunwoodie E, et al. Survival patterns in teenagers and young adults with cancer in the United Kingdom: Comparisons with younger and older age groups. *Eur J Cancer* 2015; **51**: 2643–54.

5. Pritchard-Jones K, Kaatsch P, Steliarova-Foucher E, Stiller CA, Coebergh JW. Cancer in children and adolescents in Europe: developments over 20 years and future challenges. *Eur J Cancer* 2006; **42**: 2183–90.

6. Bleyer A. OLM, Barr R, Ries LAG. Cancer epidemiology in older adolescents and young adults 15 to 29 years of age, including SEER incidence and survival: 1975–2000. Bethesda, MD: National Cancer Institute, 2006.

7. Coebergh JW, Reedijk AM, de Vries E, et al. Leukaemia incidence and survival in children and adolescents in Europe during 1978–1997. Report from the Automated Childhood Cancer Information System project. *Eur J Cancer* 2006; **42**: 2019–36.

8. Trama A, Botta L, Foschi R, et al. Survival of European adolescents and young adults diagnosed with cancer in 2000–07: population-based data from EUROCARE-5. *Lancet Oncol* 2016; **17**: 896–906.

9. Allemani C, Matsuda T, Di Carlo V, et al. Global surveillance of trends in cancer survival 2000–14 (CONCORD-3): analysis of individual records for 37,513,025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. *Lancet* 2018; **391**: 1023–75.

10. Gatta G, Capocaccia R, De Angelis R, Stiller C, Coebergh JW. Cancer survival in European adolescents and young adults. *Eur J Cancer* 2003; **39**: 2600–10.

11. Gatta G, Corazziari I, Magnani C, Peris-Bonet R, Roazzi P, Stiller C. Childhood cancer survival in Europe. *Ann Oncol* 2003; **14** (suppl 5): v119–27.

12. Fritz AG, Percy C, Jack A, et al, eds. International Classification of Diseases for Oncology (ICD-O), 3rd edn. Geneva: World Health Organization, 2000.

13. Fritz AG, Percy C, Jack A, et al, eds. International Classification of Diseases for Oncology (ICD-O). First revision of 3rd edn. Geneva: World Health Organization, 2013.

14. Steliarova-Foucher E, Stiller C, Lacour B, Kaatsch P. International Classification of Childhood Cancer, third edition. *Cancer* 2005; **103**: 1457–67.

15. Perme MP, Stare J, Estève J. On estimation in relative survival. *Biometrics* 2012; **68**: 113–20.

16. Spika D, Bannon F, Bonaventure A, et al. Life tables for global surveillance of cancer survival (the CONCORD programme): data sources and methods. *BMC Cancer* 2017; **17**: 159–73.

17. Estève J, Benhamou E, Raymond L. Statistical methods in cancer research, volume IV. Descriptive epidemiology (IARC Scientific Publications No. 128). Lyon: International Agency for Research on Cancer, 1994.

18. Brenner H, Gefeller O. An alternative approach to monitoring cancer patient survival. *Cancer* 1996; **78**: 2004–10.

19. Stiller CA, Bunch KJ. Trends in survival for childhood cancer in Britain diagnosed 1971–85. *Br J Cancer* 1990; **62**: 806–15.

20. Trama A, Bernasconi A, McCabe MG, et al. Is the cancer survival improvement in European and American adolescent and young adults still lagging behind that in children? *Pediatr Blood Cancer* 2019; **66**: e27407.

21. Bonaventure A, Harewood R, Stiller CA, et al. Worldwide comparison of survival from childhood leukaemia for 1995–2009, by subtype, age, and sex (CONCORD-2): a population-based study of individual data for 89 828 children from 198 registries in 53 countries. *Lancet Haematol* 2017; **4**: e202–17.

22. Bartram J, Veys P, Vora A. Improvements in outcome of childhood acute lymphoblastic leukaemia (ALL) in the UK - a success story of modern medicine through successive UKALL trials and international collaboration. *Br J Haematol* 2020; **191**: 562–67.

23. De Angelis R, Minicozzi P, Sant M, et al. Survival variations by country and age for lymphoid and myeloid malignancies in Europe 2000–2007: Results of EUROCARE-5 population-based study. *Eur J Cancer* 2015; **51**: 2254–68.

24. Burnusuzov HA, Yordanova MN, Avramova BE, et al. Treatment of childhood acute myeloid leukemia in Bulgaria. *Folia Med* 2018; **60**: 234–40.

25. National Cancer Center. Cancer facts and figures 2015 in the Republic of Korea. Seoul: Ministry of Health and Welfare, 2015.

26. Zhou Q, Hong D, Lu J, Zheng D, Ashwani N, Hu S. Pediatric medical care system in China has significantly reduced abandonment of acute lymphoblastic leukemia treatment. *J Pediatr Hematol Oncol* 2015; **37**: 181–84.

27. Zeng H, Chen W, Zheng R, et al. Changing cancer survival in China during 2003–15: a pooled analysis of 17 population-based cancer registries. *Lancet Glob Health* 2018; **6**: e555–67.

28. Zeng H, Zheng R, Guo Y, et al. Cancer survival in China, 2003–2005: a population-based study. *Int J Cancer* 2015; **136**: 1921–30.

29. Bleyer A, Barr R, Hayes-Lattin B, Thomas D, Ellis C, Anderson B. The distinctive biology of cancer in adolescents and young adults. *Nat Rev Cancer* 2008; **8**: 288–98.

30. Siegel SE, Stock W, Johnson RH, et al. Pediatric-inspired treatment regimens for adolescents and young adults with Philadelphia chromosome-negative acute lymphoblastic leukemia: a review. *JAMA Oncol* 2018; **4**: 725–34.

31. Nakata K, Okawa S, Fuji S, et al. Trends in survival of leukemia among children, adolescents, and young adults: a population-based study in Osaka, Japan. *Cancer Sci* 2021; **112**: 1150–60.

32. Bleyer A. The adolescent and young adult gap in cancer care and outcome. *Curr Probl Pediatr Adolesc Health Care* 2005; **35**: 182–217.

33. Drozdov D, Bonaventure A, Nakata K, Suttorp M, Belot A. Temporal trends in the proportion of “cure” in children, adolescents, and young adults diagnosed with chronic myeloid leukemia in England: a population-based study. *Pediatr Blood Cancer* 2018; **65**: e27422.

34. Force LM, Abdollahpour I, Advani SM, et al. The global burden of childhood and adolescent cancer in 2017: an analysis of the Global Burden of Disease Study 2017. *Lancet Oncol* 2019; **20**: 1211–25.

35. WHO. WHO Global Initiative for Childhood Cancer: an overview. Geneva: World Health Organization, 2018.

36. Osborn MP, Johnson RH. Worldwide benefits of improving cancer care for adolescents and young adults in LMICs. *Lancet Oncol* 2020; **21**: 487–89.

37. Atun R, Bhakta N, Denburg A, et al. Sustainable care for children with cancer: a *Lancet Oncology* Commission. *Lancet Oncol* 2020; **21**: e185–224.

38. Bleyer A, Ferrari A, Whelan J, Barr RD. Global assessment of cancer incidence and survival in adolescents and young adults. *Pediatr Blood Cancer* 2017; **64**: e26497.

39. Coleman MP. Cancer survival: global surveillance will stimulate health policy and improve equity. *Lancet* 2014; **383**: 564–73.

40. Allemani C, Coleman MP. Public health surveillance of cancer survival in the United States and worldwide: The contribution of the CONCORD programme. *Cancer* 2017; **123** (suppl 24): 4977–81.

41. Corazziari I, Quinn M, Capocaccia R. Standard cancer patient population for age standardising survival ratios. *Eur J Cancer* 2004; **40**: 2307–16.

42. Miranda-Filho A, Bray F, Charvat H, Rajaraman S, Soerjomataram I. The world cancer patient population (WCPP): an updated standard for international comparisons of population-based survival. *Cancer Epidemiol* 2020; **69**: 101802.

43. Barr RD, Ries LAG, Trama A, et al. A system for classifying cancers diagnosed in adolescents and young adults. *Cancer* 2020; **126**: 4634–59.