Survival from childhood cancer in Kampala, Uganda

Liu, Biying; Youlden, Danny R.; Wabinga, Henry; Nambooze, Sarah; Amulen, Phoebe Mary; Aitken, Joanne F.; Parkin, Donald Maxwell

doi:10.1002/pbc.28876

Cited by 5 publications

(7 citation statements)

References 7 publications

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“…Liu et al. (2021) reported on 3‐year survival for the same eight cancers in the population of Kampala in Uganda for cases diagnosed in 2010–2014 6 . Survival in Rwanda was significantly higher for retinoblastoma (72% vs. 57%) and Wilms tumour (56% vs. 30%), but lower for HL (67% vs. 86%).…”

Section: Discussionmentioning

confidence: 99%

“…6 Survival in Rwanda was significantly higher for retinoblastoma (72% vs. 57%) and Wilms tumour (56% vs. 30%), but lower for HL (67% vs. 86%). In Rwanda, 1-year survival of 72% for children aged 0−14 years with NHL (excluding BL) was higher than the 58% in Kampala in 2010-20146 or that 43% reported by the Uganda Cancer Institute12 among patients aged 0−19 years, whereas TA B L E 3…”

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confidence: 90%

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Stage at diagnosis and survival by stage for the leading childhood cancers in Rwanda

Businge,

Hagenimana,

Motlhale

et al. 2024

Pediatric Blood & Cancer

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BackgroundThe lack of accurate population‐based information on childhood cancer stage and survival in low‐income countries is a barrier to improving childhood cancer outcomes.MethodsIn this study, data from the Rwanda National Cancer Registry (RNCR) were examined for children aged 0–14 diagnosed in 2013–2017 for the eight most commonly occurring childhood cancers: acute lymphoblastic leukaemia, Hodgkin lymphoma (HL), Burkitt lymphoma (BL), non‐Hodgkin lymphoma excluding BL, retinoblastoma, Wilms tumour, osteosarcoma and rhabdomyosarcoma. Utilising the Toronto Childhood Cancer Stage Guidelines Tier 1, the study assigned stage at diagnosis to all, except HL, and conducted active follow‐ups to calculate 1‐, 3‐ and 5‐year observed and relative survival by cancer type and stage at diagnosis.ResultsThe cohort comprised 412 children, of whom 49% (n = 202) died within 5 years of diagnosis. Five‐year survival ranged from 28% (95% confidence interval [CI]: 12.5%–45.6%) for BL to 68% (CI: 55%–78%) for retinoblastoma. For the cancers for which staging was carried out, it was assigned for 83% patients (n = 301 of 362), with over half (58%) having limited or localised stage at diagnosis. Stage was a strong predictor of survival; for example, 3‐year survival was 70% (95% CI: 45.1%–85.3%) and 11.8% (2.0%–31.2%) for limited and advanced non‐HL, respectively (p < .001).ConclusionThis study is only the second to report on stage distribution and stage‐specific survival for childhood cancers in sub‐Saharan Africa. It demonstrates the feasibility of the Toronto Stage Guidelines in a low‐resource setting, and highlights the value of population‐based cancer registries in aiding our understanding of the poor outcomes experienced by this population.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 90%

Stage at diagnosis and survival by stage for the leading childhood cancers in Rwanda

Businge,

Hagenimana,

Motlhale

et al. 2024

Pediatric Blood & Cancer

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“…Table 1 gives further details on the model variables, range of values and assumptions. As there is no cancer survival registry or previously conducted childhood cancer health outcome studies in Ethiopia, treatment outcome-related data were taken from evidence in similar settings 4 30–32 40–46. We did not use treatment outcome data from high and middle-income countries, as such outcomes would require further investments in quality improvements that were not captured in our costing estimate.…”

Section: Methodsmentioning

confidence: 99%

“…An intervention was considered cost-effective if the ICER was less than 50% of the Ethiopian GDP per capita, and not cost-effective if otherwise 43. We used TreeAge software to build the decision model and run the cost-effectiveness analysis.…”

Section: Methodsmentioning

confidence: 99%

Cost-effectiveness of running a paediatric oncology unit in Ethiopia

et al. 2023

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ObjectiveTo estimate the cost-effectiveness of running a paediatric oncology unit in Ethiopia to inform the revision of the Ethiopia Essential Health Service Package (EEHSP), which ranks the treatment of childhood cancers at a low and medium priority.MethodsWe built a decision analytical model—a decision tree—to estimate the cost-effectiveness of running a paediatric oncology unit compared with a do-nothing scenario (no paediatric oncology care) from a healthcare provider perspective. We used the recently (2018–2019) conducted costing estimate for running the paediatric oncology unit at Tikur Anbessa Specialized Hospital (TASH) and employed a mixed costing approach (top-down and bottom-up). We used data on health outcomes from other studies in similar settings to estimate the disability-adjusted life years (DALYs) averted of running a paediatric oncology unit compared with a do-nothing scenario over a lifetime horizon. Both costs and effects were discounted (3%) to the present value. The primary outcome was incremental cost in US dollars (USDs) per DALY averted, and we used a willingness-to-pay (WTP) threshold of 50% of the Ethiopian gross domestic product per capita (USD 477 in 2019). Uncertainty was tested using one-way and probabilistic sensitivity analyses.ResultsThe incremental cost and DALYs averted per child treated in the paediatric oncology unit at TASH were USD 876 and 2.4, respectively, compared with no paediatric oncology care. The incremental cost-effectiveness ratio of running a paediatric oncology unit was USD 361 per DALY averted, and it was cost-effective in 90% of 100 000 Monte Carlo iterations at a USD 477 WTP threshold.ConclusionsThe provision of paediatric cancer services using a specialised oncology unit is most likely cost-effective in Ethiopia, at least for easily treatable cancer types in centres with minimal to moderate capability. We recommend reassessing the priority-level decision of childhood cancer treatment in the current EEHSP.

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“…In Uganda, the Kampala Cancer Registry recorded a 25% increase in the age-adjusted incidence of cancer over 25 years (1991–2015) [ 1 ]. The incidence of cancer in individuals aged 0–19 years is 139 per million, and overall, 3-year survival ranges from 86% for Hodgkin’s disease to 30% for Wilms tumor [ 2 ]. We define young adults as individuals transitioning into adulthood and aged 18–25 years [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Understanding Reproductive Health among Survivors of Paediatric and Young adults (URHSPY) cancers in Uganda: A mixed method study protocol

et al. 2023

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Background Although reproductive failure after cancer treatment in children and young adults has been extensively described in high-income countries, there is a paucity of data in low-income settings. In addition, patient, parent, or health worker experiences, perspectives, and attitudes toward the risk of reproductive failure among young cancer patients in these settings are unknown. This study will describe the extent of reproductive morbidity associated with cancer treatment among childhood and young adult cancer survivors in Uganda. In addition, we aim to explore the contextual enablers and barriers to addressing cancer treatment-related reproductive morbidity in Uganda. Methods This is an explanatory sequential mixed-method study. The quantitative phase will be a survey among childhood and young adult cancer survivors recruited from the Kampala Cancer Registry (KCR). The survey will utilize a Computer Assisted Telephone Interview (CATI) platform on a minimum of 362 survivors. The survey will obtain information on self-reported reproductive morbidity and access to oncofertility care. The qualitative phase will use grounded theory to explore contextual barriers and enablers to addressing reproductive morbidity associated with cancer treatment. The quantitative and qualitative phases will be integrated at the intermediate and results stage. Conclusion Results from this study will inform the development of policy, guidelines, and programs supporting reproductive health among childhood and young adult cancer survivors.

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Survival from childhood cancer in Kampala, Uganda

Cited by 5 publications

References 7 publications

Stage at diagnosis and survival by stage for the leading childhood cancers in Rwanda

Stage at diagnosis and survival by stage for the leading childhood cancers in Rwanda

Cost-effectiveness of running a paediatric oncology unit in Ethiopia

Understanding Reproductive Health among Survivors of Paediatric and Young adults (URHSPY) cancers in Uganda: A mixed method study protocol

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