Cohort studyindependent cross-checkabstract checked★ key study I-CHM-125 standard review
Childhood cancer survival in Egypt
Temporal trends in childhood cancer survival in Egypt, 2007 to 2017: A large retrospective study of 14 808 children with cancer from the Children's Cancer Hospital Egypt.
Overview
Soliman RM et al.. Int J Cancer 2021 · PMID 32997796 · DOI 10.1002/ijc.33321
At Egypt's main children's cancer hospital, 72% of children were alive 5 years after diagnosis, and survival improved over time.
Does the study support the specific claim? No · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Measure Egyptian childhood cancer survival
- How was the study done?
Hospital cohort
- How many people, animals or samples were studied?
14,808 children
- What was actually found?
Survival rising
- How large was the observed effect?
5-y OS 72.1%; 69.6% -> 74.2%
- What do the results mean in everyday life?
Treatment cures most children in Egypt too
- What are the study's limitations?
Single hospital; no untreated group
- What does it say about Elawady's specific claim?
Contradicts the futility claim
- Do the results apply to Germany and Europe?
High (Egyptian data)
- What can explicitly not be concluded from this study?
Cannot isolate the effect of each treatment
Scientific in-depth review
1. Full reference
- Authors
- Soliman RM et al.
- Journal
- Int J Cancer
- Year
- 2021
- Identifier
- PMID 32997796 DOI 10.1002/ijc.33321
- Verification
- verified – PubMed efetch 2026-10-26 (PublicationType and CommentsCorrections checked); Crossref 2026-10-26
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
WHO and UK Department of Health listed as grant sources.
2. Research question
What are survival rates and trends for children with cancer treated at CCHE-57357, Egypt?
3. Study design and population
- Study design
- Cohort study – Retrospective hospital cohort (about 40-50% of Egyptian childhood cancers)
- Population
Children 0-18 years with cancer treated at Children's Cancer Hospital Egypt
- Country
Egypt
- Period
2007-2017
- Sample size
14,808 eligible (15,779 total)
- Inclusion and exclusion criteria
All childhood cancers at CCHE
4. Methods and endpoints
- Exposure / intervention
Multimodal treatment (chemotherapy, surgery, radiotherapy) by period
- Comparator
Earlier period; England and USA benchmarks
- Endpoints
5-year overall survival
- Statistical methods
Kaplan-Meier; Cox regression by year
5. Actual results
- Results
5-year OS 72.1% (71.3-72.9) overall; increased from 69.6% (2007-12) to 74.2% (2013-17), P<.0001; improved for leukaemias, lymphomas, CNS tumours, neuroblastoma, hepatoblastoma, Ewing sarcoma; survival 9% and 11.2% lower than England and the USA.
- Absolute risks
5-year OS 72.1%
- Authors' conclusion
Survival is improving in Egypt but remains below high-income countries; recommendations to improve care.
6. Strengths
- Very large Egyptian cohort
- Benchmarking
7. Weaknesses
- Single institution (though very large)
- No untreated comparator; survival not causal proof of treatment effect
8. Risk of bias
- Orienting tool
- ROBINS-E
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Descriptive cohort.
9. Assessment of the statistical interpretation
Absolute gain 4.6 points (stats/C-CHM-13.py).
10. Relevance to the specific claim
Egypt-specific evidence that most children treated for cancer with standard multimodal therapy survive (72% at 5 years) and that outcomes improve with better care, which contradicts the claim that oncology only 'buys time'.
11. Independent contrary findings
None.
12. Transferability to Germany and Europe
Egyptian data; similar to international trends.
13. Overall methodological judgement
Strong regional context.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | some concerns |
| Precision of results | high |
| Directness | indirect |
| Reproducibility | unknown |
| Consistency with the overall evidence | consistent |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
Adult Egyptian outcomes.
15. Linked fact checks
- Cancer patients should not take chemotherapy, radiotherapy or biological therapy (or should stop them) and follow the Tayebat system instead; 'we are against the word medicine'. – Studies contradicting or limiting the claim
- Oncology only buys time: 'survival rates' are meaningless, patients die during treatment, and early diagnosis only makes you 'die early'. – Studies contradicting or limiting the claim