India among countries with the highest childhood cancer burden
Collectively, childhood cancers are the sixth biggest contributor to total cancer burden worldwide after adult cancers of the lung, liver, stomach, colon, and breast; and the ninth leading cause of childhood disease burden globally.
India, along with China, Nigeria, Pakistan, Indonesia, and the USA faces the largest burden of childhood cancer among countries with the highest population of children, a study published in The Lancet Oncology journal said.
This is the first Global Burden of Disease Study (GBD) to quantify the impact of childhood cancer in terms of years of healthy life lost to ill-health and premature death.
While the number of new cancer cases in children and adolescents (aged 0-19 years) is relatively low at around 416,500 globally in 2017, treatment-related ill-health and disability and fatal cancer are estimated to cause around 11.5 million years of healthy life lost globally every year, the study assessing childhood and adolescent cancer burden in 195 countries in 2017 said.
Children in the poorest countries face a disproportionately high cancer burden—contributing over 82 per cent of the global childhood cancer burden—equivalent to almost 9.5 million years of healthy life lost in 2017. Most (97 per cent) of this global burden is related to premature death, with around 3 per cent due to impaired quality of life.
Children with cancer who live in high-income countries tend to have good survival, with around 80 per cent surviving five years after diagnosis. But these improvements have not translated to most low-and middle-income countries (LMICs), where survival is approximately 35-40 per cent, but some estimates suggest it could be as low as 20 per cent. Around 90 per cent of children at risk of developing cancer live in LMICs.
Further, the study reveals striking inequities in childhood cancer burden between high and low SDI countries—a measure based on rates of education, fertility, and income.
High and high-middle SDI countries accounted for about 35 per cent (147,300) of new cases of childhood cancer in 2017, but only 18 per cent of DALYs (around 2 million years of healthy life lost), whereas low-middle and low Socio-Demographic Index countries with 38 per cent of global incidence (159,600 new cases) accounted for 60 per cent of Disability-Adjusted Life Years (almost 7 million years of healthy life lost).
The study puts the annual toll of childhood cancer at over 11.5 million years of healthy life lost in 2017. This compares with around 37 million years of healthy life lost globally due to malaria, and 7.6 million from tuberculosis.
In 2017, childhood cancer was among the top four biggest contributors to the burden of general diseases of childhood in middle and high-middle SDI countries, ranking higher than malaria and HIV/AIDS.
While four of the five countries with the highest childhood cancer burden were in Asia and Oceania—India, China, Pakistan, and Indonesia—the USA had the sixth-largest burden in 2017, and sub-Saharan Africa had the biggest DALY burden for more childhood cancer types than any other region.