Global Burden of Pediatric and Adolescent Cancer in 2017
A recent analysis looked at the global burden of pediatric cancer through the lens of years of affected and lost life. This work shows a much greater burden of childhood cancer, placed largely in low- and middle-income countries, than previous estimates. The findings were published in The Lancet Oncology.
Disability-Adjusted Life-Years
By using disability-adjusted life-years (the sum of years of life lost and years lived with disability) to represent the burden of childhood cancer for the first time, the researchers were able to compare cancer to other pediatric diseases like human immunodeficiency virus or tuberculosis. In childhood cancer, early deaths lead to many years of life lost, and survivors often live for extended periods with chronic disability. These affected years of life are captured when evaluating disability-adjusted life-years but are not highlighted by traditional incidence and mortality data.
This new method for assessing global childhood cancer burden will help experts plan resources and set health policy priorities. Additionally, an understanding of disability-adjusted life-years may help local governments, stakeholder groups, and the global health community identify disease priorities and focus cancer control efforts.
“Previous estimates using incidence and mortality cases put the burden of childhood cancer in the hundreds of thousands globally,” said Nickhill Bhakta, MD, of the St. Jude Children’s Research Hospital Department of Global Pediatric Medicine, in a press release. “By looking at a different metric—disability-adjusted life-years—we can now show for the first time that the burden of disease due to childhood cancer is significant and underappreciated in both the cancer and child health communities.”
Global Burden of Disease Study
In July 2018, St. Jude and the Institute for Health Metrics and Evaluation at the University of Washington announced a partnership to improve global childhood cancer burden estimates. This effort leverages both organizations’ expertise in health metrics sciences and childhood cancer care to provide more accurate estimates of the global burden of cancer among children. The Institute for Health Metrics and Evaluation runs the annual Global Burden of Disease study, which provides estimates for 359 diseases and injuries, including cancers, with more than 3,000 collaborators in nearly 150 countries and territories.
The St. Jude analysis is built upon data collected through the Global Burden of Disease 2017 study, with childhood cancer burden estimates represented by disability-adjusted life-years providing a comprehensive and comparable framework for assessing and contextualizing pediatric cancer.
Study Results
The results show that in 2017, globally, there were approximately 11.5 million disability-adjusted life-years due to childhood cancer, 97.3% of which were attributable to years of life lost.
The social and economic burden of childhood cancer is most prominent in countries on the lower end of the development spectrum, largely in Asia, Africa, and Central and South America, which experience 82.2% of all childhood cancer disability-adjusted life-years, whereas 50.3% of adult cancer disability-adjusted life-years occurred in the same locations.
“While global incidence and mortality estimates are available, there are no prior analyses of the global burden of childhood cancer represented by disability-adjusted life-years,” said first and corresponding study author Lisa Force, MD, of the St. Jude Department of Global Pediatric Medicine. “This analysis shows that childhood cancer results in substantial disease burden despite a relatively low absolute number of incident cases and deaths.”
Worldwide, more than 90% of children with cancer live in low- and middle-income countries. Many of these children lack access to adequate diagnosis and treatment. Childhood cancer was the sixth leading cause of total cancer burden globally and the ninth leading cause of childhood disease burden globally.
The authors concluded, “The Global Burden of Disease 2017 results call attention to the substantial burden of childhood cancer globally, which disproportionately affects populations in resource-limited settings. The use of disability-adjusted life-year–based estimates is crucial in demonstrating that childhood cancer burden represents an important global cancer and child health concern.”
Disclosure: The research was funded in part by the Bill & Melinda Gates Foundation, St. Baldrick’s Foundation, and ALSAC. For full disclosures of the study authors, visit 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®.
