Paediatric cancer stage in population-based cancer registries: the Toronto consensus principles and guidelines.
Population-based cancer registries generate estimates of incidence and survival that are essential for cancer surveillance, research, and control strategies. Although data on cancer stage allow meaningful assessments of changes in cancer incidence and outcomes, stage is not recorded by most population-based cancer registries. The main method of staging adult cancers is the TNM classification. The criteria for staging paediatric cancers, however, vary by diagnosis, have evolved over time, and sometimes vary by cooperative trial group. Consistency in the collection of staging data has therefore been challenging for population-based cancer registries. We assembled key experts and stakeholders (oncologists, cancer registrars, epidemiologists) and used a modified Delphi approach to establish principles for paediatric cancer stage collection. In this Review, we make recommendations on which staging systems should be adopted by population-based cancer registries for the major childhood cancers, including adaptations for low-income countries. Wide adoption of these guidelines in registries will ease international comparative incidence and outcome studies.
Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada; Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada. Electronic address: sumit.gupta@sickkids.ca.
Sumit
S
Gupta
Cancer Council Queensland, Fortitude Valley, Brisbane, QLD, Australia.
Joanne F
JF
Aitken
Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada; Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Ute
U
Bartels
Department of Radiation Oncology, Princess Margaret Hospital, Toronto, ON, Canada.
James
J
Brierley
Southern Philippines Medical Center, Bajada, Davao City, Philippines.
Mae
M
Dolendo
Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA.
Paola
P
Friedrich
Hospital Nacional de Ninos Benjamin Bloom, San Salvador, El Salvador.
Soad
S
Fuentes-Alabi
Unidad Nacional de Oncologia Pediatrica, Guatemala City, Guatemala.
Claudia P
CP
Garrido
Evaluative Epidemiology Unit, Fondazione IRCSS Instituto Nazionale dei Tumori, Milan, Italy.
Gemma
G
Gatta
Department of Radiation Oncology, Princess Margaret Hospital, Toronto, ON, Canada.
Mary
M
Gospodarowicz
Center for Global Health, National Cancer Institute, Bethesda, MD, USA.
Thomas
T
Gross
University of Memphis, Memphis, TN, USA.
Scott C
SC
Howard
College of Medicine, Blantyre, Malawi.
Elizabeth
E
Molyneux
Argentinian Oncopediatric Registry (ROHA), National Cancer Institute, Buenos Aires, Argentina.
Florencia
F
Moreno
Pediatric Oncology Group of Ontario, Toronto, ON, Canada.
Jason D
JD
Pole
Institute of Child Health, University College London, London, UK.
Kathy
K
Pritchard-Jones
Registro Poblacional de Cancer de Cali, Universidad del Valle, Oficina, Cali, Valle, Colombia.
Oscar
O
Ramirez
SEER Program, National Cancer Institute, Bethesda, MD, USA.
Lynn A G
LAG
Ries
Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA.
Carlos
C
Rodriguez-Galindo
Department of Pediatrics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea.
Hee Young
HY
Shin
Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France.
Eva
E
Steliarova-Foucher
Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada; Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Lillian
L
Sung
Pediatric Hematology Oncology Division, Department of Pediatrics, Dr Sardjito Hospital, Gadjah Mada University, Yogyakarta, Indonesia.
Eddy
E
Supriyadi
Epidemiology, Biostatistics and Cancer Registry, Cancer Institute, Chennai, India.
Rajaraman
R
Swaminathan
Union for International Cancer Control, Geneva, Switzerland.
Julie
J
Torode
Tata Memorial Hospital, Parel, Mumbai, India.
Tushar
T
Vora
Union for International Cancer Control, Geneva, Switzerland.
Tezer
T
Kutluk
Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA.
A Lindsay
AL
Frazier
D000328:Adult; D002170:Canada; D002648:Child; D017408:Guidelines as Topic; D006801:Humans; D009367:Neoplasm Staging; D009369:Neoplasms / Q000453:epidemiology / Q000473:pathology*; D010372:Pediatrics / Q000145:classification*; D012042:Registries