Childhood cancer epidemiology in low‐income countries

Abstract

Global studies of childhood cancer provide clues to cancer etiology, facilitate prevention and early diagnosis, identify biologic differences, improve survival rates in low-income countries (LIC) by facilitating quality improvement initiatives, and improve outcomes in high-income countries (HIC) through studies of tumor biology and collaborative clinical trials. Incidence rates of cancer differ between various ethnic groups within a single country and between various countries with similar ethnic compositions. Such differences may be the result of genetic predisposition, early or delayed exposure to infectious diseases, and other environmental factors. The reported incidence of childhood leukemia is lower in LIC than in more prosperous countries. Registration of childhood leukemia requires recognition of symptoms, rapid access to primary and tertiary medical care (a pediatric cancer unit), a correct diagnosis, and a data management infrastructure. In LIC, where these services are lacking, some children with leukemia may die before diagnosis and registration. In this environment, epidemiologic studies would seem to be an unaffordable luxury, but in reality represent a key element for progress. Hospital-based registries are both feasible and essential in LIC, and can be developed using available training programs for data managers and the free online Pediatric Oncology Networked Data Base (www.POND4kids.org), which allows collection, analysis, and sharing of data.

Epidemiological Profile of Retinoblastoma in Nampula Central Hospital, Mozambique

“…However, 80% of the world's children live in a low-income countries such Mozambique (LIC), where poverty, lack of public health infrastructure, high mortality rates in children under the age of 5 years, and low childhood cancer cure rates are pervasive. In such settings, studies of cancer epidemiology may seem to be an unaffordable luxury because the cost of the treatments is really high [6]. Outcomes are still very poor in sub-Saharan Africa.…”

Parents' and Health-Care Providers' Perspectives on Side-Effects of Childhood Cancer Treatment in Indonesia

“…A childhood cancer incidence of 102 per million children under 15 years in low-income countries (Howard et al, 2008;, gives rise to approximately 6.700 new Indonesian childhood cancer patients per annum.…”

Maternal residential pesticide use and risk of childhood leukemia in Costa Rica

“…Costa Rica is also one of the countries with the highest incidences of childhood leukemia in the world 18. For example, between 2001 and 2010, the age‐standardized incidence rate of childhood leukemia in Central America and the Caribbean was 45.5 cases per million children per year,19 whereas the incidence rate in Costa Rica was 56.5 cases per million children in 2008 20. The latter rate is consistent with the incidence rate observed among Hispanic children in the United States from 2006 to 2010 (59.6 cases per million per year),21 but is higher than rates found among children from other ethnicities in the United States (ranging from 29.9 to 46.9 cases per million) 21…”