94% of world’s childhood cancer deaths occur in low, middle-income countries, study finds

Ninety four per cent of childhood cancer deaths and 85% of new cases occur in low and middle-income countries, highlighting persistent inequities in healthcare access and treatment, according to a global analysis published in The Lancet journal.

Total childhood cancer deaths in 2023 were estimated at 17,000 in India, 16,000 in China, and about nine thousand each in Nigeria and Pakistan.

The analysis of data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) also estimated 377,000 new cases of childhood cancer worldwide in 2023, resulting in about 144,000 deaths.

Researchers forming the GBD 2023 Childhood Cancer Collaborators said deaths due to childhood cancer across the world reduced by 27 % from 1.97 lakh in 1990, but increased in Africa by 55.6 %.

They added that childhood cancer was the eighth leading cause of childhood deaths, with global burden contributing substantially to global childhood disease and cancer burden and weighted disproportionately towards resource-limited places.

Among nations with a low-middle sociodemographic index, including India, childhood cancer was found to be the eleventh highest contributor to global cancer deaths across all ages in 2023.

It is also the tenth highest contributor to the world’s child disability-adjusted life years (DALY) in 2023. One DALY represents the loss of one year lived in full health.

“The majority of childhood cancer burden occurred in settings with limited resources, with 85.1 % of incident cases, 94.1 % of deaths, and 94.1 % of DALYs occurring in LMICs (comprising low-income, lower-middle-income, and upper-middle-income countries by World Bank grouping),” the authors wrote.

“Global childhood cancer burden remains a substantial contributor to global childhood disease and cancer burden and is disproportionately weighted towards resource-limited settings,” they said.

Deaths due to leukaemia (45,900) was found to be the highest contributor to the world’s childhood cancer deaths, followed by cancer of brain and nervous system (23,200) and non-Hodgkin’s lymphoma (15,200, cancer of the lymph system).

“While outcomes for many childhood cancers have improved in high-income countries, these gains have not been equitably shared,” said lead author Lisa Force, from the Institute for Health Metrics and Evaluation at the University of Washington School of Medicine, US, which co-ordinates the GBD study.

“The vast majority of children with cancer live in low- and middle-income countries, where delays in diagnosis, lack of access to essential cancer treatment, and other health system limitations and barriers to care can contribute to disparities in childhood cancer burden,” Force said.

The study emphasises that improving outcomes will require an expanded investment in cancer control systems, particularly in low and middle-income countries, including referral systems that support timely diagnosis, workforce training, access to chemotherapy, surgery and radiotherapy, as well as stronger cancer registration and surveillance systems, the researchers said.