Childhood Cancer (ChiCa)

Key messages

  1. Cancer is a significant cause of childhood death in developing countries
  2. Childhood cancer is not preventable but is curable in many cases
  3. Treating childhood cancer does not have to be expensive, small investments in services yield big returns in patient life years gained
  4. Optimal diagnosis, treatment and care requires concentration of expertise and resources, supported by a robust referral network
  5. National childhood cancer strategies must be an integral part of all NCCPs and NCD plans 

Why is ChiCA important?

Each year, an estimated 176,000 children are diagnosed with cancer with the majority living in low- and middle-income countries (LMICs). This is likely to be an underestimate as many countries do not have pediatric oncology registries, and cases frequently go unreported. While the proportion of cancer in children is small compared with the burden of adult cancers globally, cancer is an important cause of child mortality with an estimated 90,000 deaths per year.  In high-income countries, cancer is the second cause of death among 5-14 year olds after accidents and injuries. 

The good news is that most childhood cancers can be cured if prompt and essential treatment is accessible and affordable. In high-income countries, survival rates for childhood cancer are 80% and higher for some cancers. However, the proportion of children surviving cancer in low and middle income contexts is far lower, falling to as low as 10% in some countries. In many settings, there are barriers at all levels of cancer care, from early detection and diagnosis to access to cancer drugs and treatment and availability of palliative care, including pain relief. 

What are the issues in low- and middle-income countries?

  • In many countries, childhood cancer is often detected too late
  • Health workers frequently do not have sufficient knowledge and awareness of warning signs of childhood cancer
  • Referral systems for diagnosis, treatment and care for childhood cancer are weak or non- existent 
  • Expertise in childhood cancer management is insufficient 
  • Cancer drugs and treatment is often not available or affordable 
  • Palliative care services are limited with pain relief medications frequently unavailable  
  • Childhood cancer statistics are inaccurate with many cases and deaths going unreported