Comparative oncology, an integrative part of One Health approach (poster)

Ana-Maria Coman1,3, Cristina Niţu1, Nicolae Manolescu2,3 

1. “Prof. Dr. Alexandru Trestioreanu” Institute of Oncology, Bucharest, Romania
2. Academy of Medical Science of Romania – One Health Institute of Comparative Medicine
3. Faculty of Veterinary Medicine, “Spiru Haret” University, Bucharest, Romania

One Health is a multidisciplinary concept that addresses, worldwide, real health problems for humans, domestic and wild animals health and the surrounding environment. Recognizing that human and animal health are interdependent and linked to the health of the ecosystems in which they exist. One Health seeks to promote, improve and defend the health and well-being of all species by strengthening collaboration between human doctors, veterinarians and all other occupational categories with a role in health care. The comparative medicine is a fundamental part of the new One Health medical concept, with major implications for the translational and biomedical research of human and animal pathology. The basic components of comparative medicine are represented by zoonosis and comparative oncology. Comparative oncology is a cross-disciplinary approach that has recently gained significant importance due to the strong anatomical and physiological similarities between mammals and humans, especially dogs, which have been used for a long time, both in preclinical drug testing and as a toxicological model and, most importantly, in the study of pathogenesis (the study of cancer-associated genes and proteins) and in cancer therapy. 

Ten years of registering childhood cancers in the pediatric oncohematology network from Romania

Monica Dragomir1, Codruţa Comşa1, Mihaela Bucurenci2, Dana Coza3

1. “Prof. Dr. Alexandru Trestioreanu” Institute of Oncology, Bucharest, Romania
2. Romanian Society of Pediatric Oncohematology
3. “Prof. Dr. Ion Chiricuţă” Institute of Oncology, Cluj-Napoca, Romania

Background. With a number of new cases smaller than 5/10,000, childhood cancer is a rare disease whose registration at an as large as possible populational scale is essential for knowing the incidence and survival, for clinical research, and for laying the foundation of healthcare policies. For this reason, the International Agency for Research on Cancer (IARC) recommends the national registration of the new cases of childhood cancer. In Romania, the registration of newly diagnosed cases in the pediatric oncohematology national network was initiated by the Romanian Society of Pediatric Oncohematology, in the year 2010, with the technical support of the experts in cancer epidemiology and biostatistics from the “Prof. Dr. Ion Chiricuţă” Institute of Oncology, Cluj-Napoca. The National Registry of Childhoold Cancers from Romania (RNCCR) is financed exclusively from non-governmental funds. In 2018, it was accepted for affiliation to the European Network of Cancer Registries (ENCR). In 2019, it was performed the first study regarding survival on national data for the 2010-2015 cohort, with the technical assistance of the specialists from JRC – Cancer Information Unit of the European Commission. This paper presents the most important results and trends registered in childhood cancer in Romania in the last 10 years. Materials and method. The National Registry of Childhoold Cancers from Romania comprises cancer cases at the 0-19 years old age group, that were registered in the network of the 13 pediatric oncology from Romania beginning with 1.01.2010. The cases are electronically notified on the ONCPED secured platform, operated by specialists of the Northwest Regional Cancer Registry (“Prof. Dr. Ion Chiricuţă” Institute of Oncology, Cluj-Napoca) by instructed registrars from each pediatric oncohematology center, through completing the ONC form (data set and definitions recommended by ENCR and implemented in Romania by WHO 2027/2007). In 2019, the data set was completed with clinical data and there was implemented the newest staging system of childhood cancers recommended by the Toronto Consensus, RNCCR thus becoming one of the most modern and dynamic cancer registries in the Central and Eastern Europe. The tumors’ coding is performed according to the International Classification of Diseases for Oncology, 3rd edition, and the International Classification of Childhood Cancers, 3rd edition (ICCC-3). Results. Between 1.01.2010 and 31.12.2019, there had been registered 5318 notifications, representing a total of 3997 new cases, with an anual mean of approximately 400 new cases and an average gross incidence of 10.54/100,000 children of 0-14 years old, respectively 9.54/100,000 individuals of 0-19 years old. The distribution of new cases on ICCC3 diagnosis classes is dominated by leukemias (31%), followed by lymphomas (16%), SNC tumors (14%), osseous and soft tissue tumors (approximately 7% each), neuroblastoma and tumors with epithelial cells (approximately 6% each), renal tumors and tumors with germinal cells (approximately 5% each). Between 2010 and 2017, the stage at diagnosis was registered only for 57% of the stageable tumors. After the introduction of the reporting format adapted to pediatric oncology and of the Toronto staging system (which alows the recording of the disease extention degree for all localizations), the procentage of cases with extension at diagnosis reached 88%. In 2019, it was performed the first study regarding survival at a national level for the cohort of 2463 cases diagnosed between 1.01.2010 and 31.12.2015. The five-year global survival (cases diagnosed between 2010 and 2013) was 69.1%. The one-year survival and the three-year survival were 85% and 72%, respectively. The five-year survival according to localization is over 80% for lymphomas, renal tumors and retinoblastoma. The only localizations with a survival below 50% were for osseous tumors. Conclusions. The reporting of new cases which present in the Romanian pediatric oncohematology network is performed completely, correctly and on time, and results in stable gross and standardized incidence in the last 10 years (for both 0-14 and 1-19 years old age groups), along with a casuistry distribution according to localizations similar to the one of the Eastern Europe region. Regarding the results of our activity, the five-year survival in Romania is very close to the mean of Eastern Europe region (69.1% versus 70%), with a gap of approximately 10% compared to the European Union mean, according to EUROCARE study, which assigns the cancer survival differences between East and West mainly to differences in the resources allocated to their healthcare systems, especially regarding drug supply, organization of multidisciplinary services, possible diagnosis and treatment delays, and eventual difficulties in the therapeutic and side effects management.