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Analysis Reveals Substantial Childhood Cancer Burden

As technology and health care progress, the rate of children who survive five years after being diagnosed with cancer is 80%; however, this rate only applies to children who live in high-income countries (HICs). Those children that live in low-income and middle-income countries (LMICs) make up more than 90% of children who are at risk of developing cancer, and, unfortunately, children who live in LMICs lack the resources necessary to combat childhood cancer compared with children who live in HICs. Also lacking in LMICs is available data to accurately determine childhood cancer incidence and outcomes.

To allow for accurate resource allocation and efficient management of health policies to ultimately increase cancer survival in children in low-income populations, researchers set out to close the knowledge gap by using the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 methodology to calculate childhood cancer mortality and incidence.

The investigators used the GBD to estimate cancer mortality by using the vital registration system data, verbal autopsy data, and population-based cancer registry incidence data. This information was then transformed using mortality estimates to incidence-to-mortality ratios (MIRs). Mortality estimates and MIRs were then used to calculate childhood cancer incidence. Years lived with disability (YLDs) were determined by using MIR to model survival and multiplied by disability weights. In addition, age-specific cancer deaths were multiplied by the difference between the age of death and a reference life expectancy to obtain years of life lost (YLLs). Disability-adjusted-life-years (DALYs) were the addition of YLLs and YLDs. According to the World Health Organization, one DALY can be thought of as one lost year of 'healthy' life.

The results revealed 11.5 million DALYs because of childhood cancer, YLLs comprised 97.3%, and 2.7% were attributable to YLDs. It was found that childhood cancer was the sixth leading cause of total cancer burden globally; in addition, childhood cancer is the ninth leading cause of childhood disease burden globally. The majority (82.2%) of global childhood cancer DALYs occurred in low, low-middle, or middle sociodemographic index locations compared with 50.3% of adult cancer DALYs occurring in the same locations.

The study authors conclude, "The GBD 2017 results call attention to the substantial burden of childhood cancer globally, which disproportionally affects populations in resource-limited settings. The use of DALY-based estimates is crucial in demonstrating that childhood cancer burden represents an important global cancer and child health concern."

For More Information

Force LM, Abdollahpour I, Advani SM, et al (2019). The global burden of childhood and adolescent cancer in 2017: an analysis of the Global Burden of Disease Study 2017. Lancet Oncol. [Epub ahead of print] DOI:10.1016/S1470-2045(19)30339-0

Image Credit: Prashant Shrestha. Courtesy of Wikimedia Commons. Licensed under CC BY 2.0

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