Unlike cancers common in adults, childhood cancers are unlikely to be prevented by screening.
As the population continues to increase over time, the incidence of childhood and adolescent cancer will rise as well, with the burden of years of lost life to childhood cancer falling hardest on low-income countries, according to recent research.
A report, published by The Lancet Oncology, explained the result of a study conducted by Lisa Force and colleagues which evaluated the global burden of childhood cancer in disability-adjusted life-years (DALYs) and considered the loss of healthy life-years to ill health and disability in addition to death.
The study found that high and high-middle sociodemographic index countries accounted for 35% of global childhood and adolescent cancer incidence, yet only 18% of DALYs. However, globally, years of life lost represent 97.3% of DALYs and only 2.7% of years lived with disability, while years lived with disability to total DALYs ranges from 9% in high and high-middle countries to less than 1% in low-middle and low socio-demographic index countries.
“Childhood and adolescent cancer is much less amenable to prevention than many major cancers of adults, for which risk factors can be reduced or even eliminated,” the author explained. “The history of population screening for childhood cancer is not encouraging. The only feasible target was neuroblastoma, but screening led to overdiagnosis of cases that would have regressed without symptoms and had no effect on mortality from the more aggressive forms of this cancer.”
The report suggested that earlier diagnosis through increased public and clinical awareness could result in a short-term rise in global burden for children since fewer cancers would be diagnosed after the age of 20. However, earlier diagnosis could bring substantial reductions in mortality and long-term morbidity, noted the author.
“More than half a century of progress in therapy and supportive care for children with cancer has resulted in impressive gains in survival and corresponding reductions in population mortality rates in high-income countries,” noted the report. “However, this success has come at the price of increased long-term morbidity and mortality among survivors compared with the general population, which must also be counted as part of the cancer burden.”
Improved diagnostic and treatment facilities with universal access, as well as international collaboration are essential for the benefits of early diagnosis to be realized and utilized.
Stiller C. Global burden of childhood cancer: growing, but controllable [published online July 29,
2019]. Lancet Oncol. doi.org/10.1016/S1470-2045(19)30424-3.