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    Why do so many kids die so soon following a cancer diagnosis?

    Nearly 8% of childhood cancer deaths in a recent study occurred less than a month after diagnosis, often before treatment could even be started.

    The analysis recently published in the Journal of Clinical Oncology reveals that the number of early childhood cancer deaths identified in the study are higher than previous estimates made through clinical trials.

    “I was surprised by the number of our patients who die so soon after diagnosis that they’re unable to benefit from the advances that have been made in treatment,” says Adam Green, MD, assistant professor of pediatrics at the University of Colorado School of Medicine in Aurora and attending physician in pediatric hematology/oncology at Children’s Hospital Colorado, and lead author of the study. “I was also surprised by how much more commonly this happens than is reported by clinical trials, indicating that the majority of these patients are likely dying before they can start any treatment, and are also disproportionately not enrolling on trials.”

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    The study sought to examine why, despite advances in childhood cancer care, some children still die soon after a diagnosis, never making it to treatment or past early interventions.

    Researchers used data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program on more than 36,000 patients aged 0 to 19 years who were diagnosed with cancer between 1992 and 2011.

    About 1.5% of the children studied died within 1 month of their initial cancer diagnosis, accounting for 7.5% of the total deaths in the entire cohort. Those most at risk of early death were children diagnosed with acute myeloid leukemia (AML), infant acute lymphoblastic leukemia (ALL), hepatoblastoma, and malignant brain tumors. Children aged younger than 1 year at the time of diagnosis also had higher risks of early deaths, as well as children of black or Hispanic ethnicity. Children from counties with lower than median average income levels were found to have higher rates of hematologic cancers, although the percentage of early deaths from hematologic malignancies decreased significantly over the study period.

    To date, there has been little research of knowledge about pediatric oncology outcomes outside of clinical trials—an environment in which researchers believe early death may be underreported as these children die before enrollment or become ineligible because of critical illness at the onset of the trial.

    NEXT: How the research compares to earlier research

    Rachael Zimlich, RN
    Rachael Zimlich is a freelance writer in Cleveland, Ohio. She writes regularly for Contemporary Pediatrics, Managed Healthcare ...


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