Cancer of childhood in sub-Saharan Africa

Abstract

Measurement of incidence rates of childhood cancer in Africa is difficult. The study ‘Cancer of Childhood in sub Saharan Africa’ brings together results from 16 population-based registries which, as members of the African Cancer Registry Network (AFCRN), have been evaluated as achieving adequate coverage of their target population. The cancers are classified according to the third revision of the International Classification of Childhood Cancer (ICCC-3) and recorded rates in Africa are compared with those in childhood populations in the UK, France, and the USA.It is clear that, in many centres, lack of adequate diagnostic and treatment facilities leads to under-diagnosis (and enumeration) of leukaemias and brain cancers. However, for several childhood cancers, incidence rates in Africa are higher than those in high-income countries. This applies to infection-related cancers such as Kaposi sarcoma, Burkitt lymphoma, Hodgkin lymphoma and hepatocellular carcinoma, and also to two common embryonal cancers - retinoblastoma and nephroblastoma. These (and other) observations are unlikely to be artefact, and are of considerable interest when considering possible aetiological factors, including ethnic differences in risk (and hence genetic/familial antecedents).The data reported are the most extensive so far available on the incidence of cancer in sub Saharan Africa, and clearly indicate the need for more resources to be devoted to cancer registration, especially in the childhood age range, as part of an overall programme to improve the availability of diagnosis and treatment of this group of cancers, many of which have—potentially—an excellent prognosis.

Epidemiological review of childhood cancers in central Sudan

“…24,28,36 This is in contrast to previous studies from other African countries that reported lymphomas as the most common tumours affecting the paediatric population. 11,22,34 We found that the majority of children with lymphomas were older than 5 years, which is similar to the findings of a recent report from Yemen. 29 In HICs, CNS tumours are the second most diagnosed cancers and represent 20% to 27% of all paediatric cancers.…”

“…34,41 The data from Africa suggest that, in many of the populations of sub-Saharan Africa, rates are rather higher than in HICs. 11 We found that most retinoblastomas occurred in children younger than 5 years, which is similar to findings reported in other studies. 11,42,43 Although retinoblastoma is highly curable if diagnosed early, most children with retinoblastoma who are referred to the NCI are at an advanced stage.…”

“…11 We found that most retinoblastomas occurred in children younger than 5 years, which is similar to findings reported in other studies. 11,42,43 Although retinoblastoma is highly curable if diagnosed early, most children with retinoblastoma who are referred to the NCI are at an advanced stage. 44 Malignant bone tumours comprise approximately 5% of childhood neoplasms.…”

“…Low frequencies of neuroblastoma have also been reported in other sub-Saharan African countries, the percentage was between 3% and 5% of all childhood cancers seen (except Madagascar, where the frequency was 7.5%). 11 As expected, we found that most neuroblastoma cases occurred in children younger than 9 years, with the majority occurring in children younger than 5 years. We found that neuroblastoma predominantly affected female children.…”

“…The data reported were extracted from six population-based cancer registries, which, as members of the African Cancer Registry Network, have been evaluated as achieving a reasonable degree of population coverage. 11 In Sudan, where 40% of the population is under the age of 15 years, the true incidence of childhood cancers is unknown because of the lack of a national cancer registry. Reports of the occurrence of childhood cancers in Sudan are limited.…”