Global issues and opportunities for optimized retinoblastoma care

Abstract

The RB1 gene is important in all human cancers. Studies of human retinoblastoma point to a rare retinal cell with extreme dependency on RB1 for initiation but not progression to full malignancy. In developed countries, genetic testing within affected families can predict children at high risk of retinoblastoma before birth; chemotherapy with local therapy often saves eyes and vision; and mortality is 4%. In less developed countries where 92% of children with retinoblastoma are born, mortality reaches 90%. Global collaboration is building for the dramatic change in mortality that awareness, simple expertise and therapies could achieve in less developed countries.

Survival of retinoblastoma in less-developed countries impact of socioeconomic and health-related indicators

“…Early diagnosis campaigns directed at the general population have been carried out in some countries in order to improve the situation 2 14. The important role of maternal and child health indicators in the survival of patients with retinoblastoma justifies developing campaigns targeted to the public to increase awareness.…”

“…As opposed to most other malignancies, these excellent results may be more related to early diagnosis than to the availability of sophisticated treatments. Despite 90% of children affected with retinoblastoma who live in less-developed countries (LDCs), the published literature from this region has received little attention 2. The reasons for this are manyfold.…”

Strategies to manage retinoblastoma in developing countries

“…In developed countries, sophisticated conservative treatments are applied in order to preserve eyes with useful vision without affecting survival [3,4]. Although these results and trends are encouraging, the majority of the 8,000 children affected worldwide have not benefited from these trends [5].…”

Challenging the global retinoblastoma survival disparity through a collaborative research effort

“…Global collaboration is key to solving the retinoblastoma survival inequity 8 22. An open dialogue between DCs and LDCs, with an aim of achieving not only best care, but also best research practices, can build upon evidence-based care.…”