There are numerous deterrents to knowing the status of cancer globally. The most significant of which is the absence of data collection in low- and middle-income countries (LMIC), whose citizens represent a significant percentage of the world’s population. Even when registries do exist, problems often prevail. There may be variations in registration techniques, case eligibility criteria, interpretations of standards, and coding applications. This LMIC phenomenon results in health policy being based on other countries’ data, which may not be applicable. Because of limited resources in these low- and middle-income countries, collection of childhood cancer data may not be a priority due to the small numbers of overall malignancies they represent.
Two decades have passed since any attempt has been made to report and compare data on pediatric malignancies worldwide.1 The International Agency for Research on Cancer, in collaboration with the International Association of Cancer Registries, recently published their results on children diagnosed before age 20, which comprised data from 153 registry databases in 62 countries.2 Findings were presented for 19 United Nations–defined regions (Sub-Sahara Africa, Central America and the Caribbean, South America, North America, East Asia, South Asia [India only], Southeast Asia, West Asia, Eastern Europe, Northern Europe, Southern Europe, Western Europe, Oceania) from 2001-2010 and included the following:
385,509 cases of cancer occurred in children younger than age 20 worldwide; of these, children between 15 and 19 years had half the incidence of children between 0 and 14;
Across all regions, incidence rates were higher in boys than girls;
Tumor types varied by age group:
in children under the age of 4 years in all regions, leukemia represented more than a third (36.1%) of all cases;
in Sub-Sahara Africa, 42% of all soft-tissue sarcomas in children younger than 14 were Kaposi sarcoma;
in children age 15 to 19, lymphoma was most common overall; however, in this age group, leukemia was most common in South America, South Asia (India), and Southeast Asia.
Overall incidences in childhood cancer increased over the last two decades.2
Although there are limitations to these findings, they posit important epidemiologic considerations about cancer’s potential etiologies. The association of viral triggers within Africa’s cancers and pesticide exposure linked to leukemia in Southeast Asia offer some important variables to consider in the evolution of pediatric cancers.3
1. Parkin DM, Kramarova E, Draper G, et al. International Incidence of Childhood Cancer, volume 2. Lyon: International Agency for Research on Cancer, 1998.
2. Steliarova-Foucher E, Columbet M, Ries LA, et al. International incidence of childhood cancer, 2001-2010: A population-based registry study. Lancet Oncol. 2017;18:719-31.
3. Hernandez AF, Menendez P. Linking pesticide exposure with pediatric leukemia: Potential underlying mechanisms. Int J Mol Sci. 2016;17: 461.
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