Global Incidence of Undiagnosed Pediatric Cancers
Nearly half of all childhood cancers are not being diagnosed globally, according to a new modeling study published by Ward et al in The Lancet Oncology.
“Our model suggests that nearly one in two children with cancer are never diagnosed and may die untreated,” said lead study author Zachary Ward, MPH, a doctoral student in health policy at Harvard T.H. Chan School of Public Health, in a statement. “This new model provides specific estimates of childhood cancer that have been lacking.”
Accurate estimates of childhood cancer incidence are needed to inform health policies, but many countries don’t have cancer registries that quantify this incidence. In addition, existing registries may underestimate the true incidence of childhood cancer, according to the authors.
Study Findings
In the new study, researchers developed a model to simulate childhood cancer incidence for 200 countries and territories worldwide. The model included data from cancer registries in countries where they exist. It also took into account trends in population growth and urbanization, geographic variation in cancer incidence, and health system barriers to access and referral that contribute to underdiagnosis.
The study found that, in 2015, there were 397,000 cases of childhood cancer worldwide, but only 224,000 were diagnosed. The prevalence of undiagnosed cancer cases varied widely across regions, from 3% in western Europe and North America to 57% in western Africa, the study estimated. In south Asia, 49% of cases were undiagnosed. The researchers said that 92% of new cases of cancer are occurring in low- and middle-income countries, a higher proportion than previously thought.
Study authors also estimated that if health systems around the world don’t improve, 2.9 million out of 6.7 million projected childhood cancer cases—43%—will be missed between 2015 and 2030. The authors hope that their findings will help guide health systems in setting new policies to improve diagnosis and management of childhood cancers.
“Health systems in low-income and middle-income countries are clearly failing to meet the needs of children with cancer,” said Rifat Atun, FRCP, Professor of Global Health Systems and senior author of the study. “Universal health coverage, a target of United Nations Sustainable Development Goals, must include cancer in children as a priority to prevent needless deaths.”
Disclosure: Funding for the study came from Boston Children’s Hospital, Dana-Farber Cancer Institute, Harvard T.H. Chan School of Public Health, Harvard Medical School, the National Cancer Institute, SickKids, St. Jude Children’s Research Hospital, and the Union for International Cancer Control. The study authors' full disclosures can be found at thelancet.com.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
