Global and regional estimates of orphans attributed to maternal cancer mortality in 2020

Abstract

Despite women being disproportionally affected by cancer deaths at young ages, there are no global estimates of the resulting maternal orphans, who experience health and education disadvantages throughout their lives. We estimated the number of children who became maternal orphans in 2020 due to their mother dying from cancer in that year, for 185 countries worldwide and by cause of cancer-related death. Female cancer deaths—by country, cancer type and age (derived from GLOBOCAN estimates)—were multiplied by each woman’s estimated number of children under the age of 18 years at the time of her death (fertility data were derived from United Nations World Population Prospects for birth cohort), accounting for child mortality and parity-cancer risk associations. Globally, there were 1,047,000 such orphans. Over half of these were orphans due to maternal deaths from breast (258,000, 25%), cervix (210,000, 20%) and upper-gastrointestinal cancers (136,000, 13%), and most occurred in Asia (48%: India 15%, China 10%, rest of Asia 23%) and Africa (35%). Globally, there were 40 new maternal orphans due to cancer per 100,000 children, with a declining trend with a higher Human Development Index (range: 121 in Malawi to 15 in Malta). An estimated 7 million children were prevalent maternal orphans due to cancer in mid-2020. Accelerating the implementation of the World Health Organization’s cervical and breast cancer initiatives has the potential to avert not only millions of preventable female cancer deaths but also the associated, often-overlooked, intergenerational consequences of these deaths.

Orphanhood and caregiver death among children in the United States due to all-cause mortality 2000-2021: A Modeling Study

“…Orphanhood prevalence was highest in West Virginia, New Mexico, Mississippi, Louisiana, and Kentucky, affecting 1 of every 25 children. Compared to previous cause-specific reports (an estimated 97,376 children orphaned by HIV/AIDS (1998), 27 157,183 by maternal cancers (2020), 23 and 218,800 by COVID-19 in 2020-2022 38 ), data on all-cause orphanhood and co-residing grandparent caregiver death are over ten times greater, quantifying the full burden.…”

“…These established frameworks raise the possibility that new standards of care can be extended for any child experiencing orphanhood, regardless of cause. 23…”

“…24 In the U.S., the pandemic was linked to increased challenges including substance use, economic crises, mental health distress, and may have been linked to deaths due to overdose, suicide, and excessive alcohol use. 25,26 Though reports have described the U.S. orphanhood burden related to HIV, 27 maternal cancers, 23 COVID-19, 15 and child bereavement, 28 up-to-date estimates on all-cause orphanhood do not exist.…”

Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

“…2 One recent study illustrated the profound impact of disproportional cancer mortality in women: an estimated one million children became maternal orphans in 2020 because their mother died from cancer in that year, with close to one half of these orphans the result of maternal deaths from either female breast or cervical cancer. 3 In this article, we explore the cancer burden worldwide in 2022 based on the latest GLOBOCAN estimates produced by the International Agency for Research on Cancer (IARC) and disseminated as Cancer Today on the Global Cancer Observatory. 4 As with previous reports, [5][6][7][8] our lines of inquiry are threefold: (1) the description of the cancer incidence and mortality burden at the global level, (2) the geographic variability observed across 20 predefined world regions, and (3) a prediction of the future magnitude of the incidence burden (in the year 2050) based on global demographic projections.…”

“…In addition to being an important barrier to increasing life expectancy, cancer is associated with substantial societal and macroeconomic costs that vary in degree across cancer types, geography, and gender 2 . One recent study illustrated the profound impact of disproportional cancer mortality in women: an estimated one million children became maternal orphans in 2020 because their mother died from cancer in that year, with close to one half of these orphans the result of maternal deaths from either female breast or cervical cancer 3 …”