Childhood Cancer Awareness Month

Cancer is aleading cause of death for children and adolescents. The likelihood ofsurviving a diagnosis of childhood cancer depends on the country in which thechild lives; in high-income countries, more than 80% of children with cancerare cured, but in many LMICs (low-and middle-income countries ) less than 30% are cured.[1]

Cancer typesthat occur in children are different from the cancer types that more commonlyoccur in adults. The most recent the International Agency for Research onCancer (IARC) estimate of the number of new cases of cancer occurring inchildren (ages 0–19 years) worldwide is about 275 000 per year. The mostcommon cancer types in this age group are leukaemias, lymphomas, and centralnervous system tumours, and the overall incidence has two separate peaks, atages 0–4 years and 15–19 years.[2]

Althoughchildhood cancer cannot generally be prevented or identified through screening,most types of childhood cancer can be cured with generic medicines and otherforms of treatment, including surgery and radiotherapy.[3]

The reasons forlower survival rates in LMICs include delay in diagnosis, an inability toobtain an accurate diagnosis, inaccessible therapy, abandonment of treatment,death from toxicity (side effects) and avoidable relapse. Improving access tochildhood cancer care, including to essential medicines and technologies, ishighly cost-effective, feasible and can improve survival in all incomesettings.³

Causes

Cancer occursin people of all ages and can affect any part of the body. It begins withgenetic change in single cells, that can then grow into a mass (or tumour),invade other parts of the body and cause harm and death if left untreated.Unlike cancer in adults, most childhood cancers do not have a known cause. Manystudies have sought to identify the causes of childhood cancer, but very fewcancers in children are caused by environmental or lifestyle factors. Cancerprevention efforts in children should focus on behaviours that will prevent thechild from developing preventable cancer as an adult.¹

Current datasuggest that approximately 10% of all children with cancer have apredisposition because of genetic factors.¹ Further research isneeded to identify factors impacting cancer development in children.

Improvingoutcomes of childhood cancer

Because it isgenerally not possible to prevent cancer in children, the most effectivestrategy to reduce the burden of cancer in children and improve outcomes is tofocus on a prompt, correct diagnosis followed by effective, evidence-basedtherapy with tailored supportive care.¹

·      Earlydiagnosis: Earlydiagnosis in childhood cancer increases survival, makes treatment lessintensive and costly, and reduces suffering. It requires families and primaryhealth-care providers to recognize symptoms, timely and accurate diagnosis, andquick access to treatment. Warning signs such as fever, persistent headaches,bone pain, and weight loss can be detected early. Screening is generally noteffective, but in certain hereditary cases like retinoblastoma, geneticcounselling and regular monitoring may be recommended.¹

·      Treatment: Withaccurate diagnosis and access to essential treatments such as chemotherapy,surgery, radiotherapy, and supportive care, over 80% of childhood cancers canbe cured. Continued follow-up is vital to monitor recurrence and managelong-term effects of treatment.¹

·       Palliativecare: Palliative care aims to relieve pain and symptoms,improving the quality of life for children with cancer and their families fromdiagnosis through all stages of care. It can be provided at home or in thecommunity, with access to pain relief medicines like oral morphine beingessential, especially in advanced stages of the disease.¹

Incollaboration with WHO, the International Agency for Research on Cancer (IARC),the International Atomic Energy Agency (IAEA), and other UN agencies andpartners on childhood cancer, the WHO is:¹

·      increase political commitment forchildhood cancer control¹;

·      support governments to develophigh-quality cancer centres and regional satellites to ensure early andaccurate diagnosis and effective treatment¹;

·      develop standards and tools to guide theplanning and implementation of interventions for early diagnosis, treatment andpalliative and survivorship care¹,

·      improve access to essential medicines andtechnologies¹; and

·      support governments to safeguard familiesof children with cancer from financial harm and social isolation as a result ofcancer care.¹

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