Development of paediatric non-stage prognosticator guidelines for population-based cancer registries and updates to the 2014 Toronto Paediatric Cancer Stage Guidelines

Sumit Gupta, Joanne Aitken, Ute Bartels, Nickhill Bhakta, Mihaela Bucurenci, James D. Brierley, Beatriz De Camargo, Eric Chokunonga, Jessica Clymer, Dana Coza, Chris Fraser, Soad Fuentes-Alabi, Gemma Gatta, Thomas Gross, Zsuzsanna Jakab, Betsy Kohler, Tezer Kutluk, Florencia Moreno, Kayo Nakata, Sari NurD. M. Parkin, Lynne Penberthy, Jason Pole, Jenny N. Poynter, Kathy Pritchard-Jones, Oscar Ramirez, Lorna Renner, Eva Steliarova-Foucher, Michael Sullivan, Rajaraman Swaminathan, Liesbet Van Eycken, Tushar Vora, A. L. Frazier

Research output: Contribution to journalReview articlepeer-review


Population-based cancer registries (PBCRs) generate measures of cancer incidence and survival that are essential for cancer surveillance, research, and cancer control strategies. In 2014, the Toronto Paediatric Cancer Stage Guidelines were developed to standardise how PBCRs collect data on the stage at diagnosis for childhood cancer cases. These guidelines have been implemented in multiple jurisdictions worldwide to facilitate international comparative studies of incidence and outcome. Robust stratification by risk also requires data on key non-stage prognosticators (NSPs). Key experts and stakeholders used a modified Delphi approach to establish principles guiding paediatric cancer NSP data collection. With the use of these principles, recommendations were made on which NSPs should be collected for the major malignancies in children. The 2014 Toronto Stage Guidelines were also reviewed and updated where necessary. Wide adoption of the resultant Paediatric NSP Guidelines and updated Toronto Stage Guidelines will enhance the harmonisation and use of childhood cancer data provided by PBCRs.

Original languageEnglish (US)
Pages (from-to)e444-e451
JournalThe Lancet Oncology
Issue number9
StatePublished - Sep 2020

Bibliographical note

Funding Information:
Where authors are identified as personnel of the International Agency for Research on Cancer or WHO, the authors alone are responsible for the views expressed in this Policy Review and they do not necessarily represent the decisions, policy, or views of the International Agency for Research on Cancer or WHO. KP-J is funded in part by the National Institute for Health Research and Great Ormond Street Hospital Biomedical Research Centre. KN reports grants from the Ministry of Health, Labour, and Welfare of Japan, during the conduct of the study. CF reports personal fees from Amgen and Novartis, outside the submitted work. LVE reports grants from the National Institute for Sickness and Disability Insurance, during the conduct of the study. All other authors declare no competing interests.

Funding Information:
The consensus meeting was funded by the Garron Family Cancer Centre at the Hospital for Sick Children. The funding source had no influence on the proceedings of the meeting, the decision to publish, or the writing of the manuscript. We thank Cancer Australia for their support through a national initiative to improve population cancer data on stage, treatment, and recurrence. We thank Meghan Cook and Veda Zabih (The Hospital for Sick Children, Toronto, ON, Canada) for their effort and help in coordinating the consensus process, and Anastasia Dolya and Katiuska Veselinovic (International Agency for Research on Cancer, Lyon, France) for their help with the meeting organisation.

PubMed: MeSH publication types

  • Journal Article
  • Research Support, Non-U.S. Gov't
  • Review

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