Childhood cancer accounted for 11.5 million years of healthy life lost in 2017, with lower-resource nations facing a significantly larger burden than high-income countries, according to an analysis of the Global Burden of Disease Study published in The Lancet Oncology.
“By assessing the global burden of childhood cancer through the lens of disability-adjusted life years [DALYs], we can more comprehensively understand the devastating impact of cancer on children globally,” Lisa Force, MD, clinical fellow of oncology and global pediatric medicine at St. Jude Children’s Research Hospital, said in a press release. “Our findings are an important first step in establishing that childhood cancer has a role in frameworks that address global oncology and global child health.”
Researchers calculated DALYs by estimating the number of healthy life-years children and adolescents ages 0 to 19 years with cancer lost because of illness, disability or premature death. One DALY is equivalent of one healthy year of life lost.
They estimated cancer mortality using data from vital registration systems, verbal autopsies and population-based cancer registries.
Results showed 11.5 million (95% uncertainty interval [UI], 10.6-12.3) DALYs in 2017 due to childhood cancer, with 97.3% because of years of life lost and 2.7% because of years lived with disability. Children ages 0 to 4 years appeared to be the highest contributors to childhood cancer DALYs, representing 37% (n = 4.3 million) of the global burden. Leukemias represented the highest proportion of the childhood cancer DALY burden (34.1%), followed by brain and nervous system cancers (18.1%).
Childhood cancer ranked sixth among leading causes of total cancer burden in the world — behind cancers of the lung, liver, stomach, colon and rectum, and breast — and ninth among causes of childhood disease burden globally.
About 82% of global childhood cancer DALYs occurred in low, low-middle, or middle sociodemographic index (SDI) locations, which researchers established based on rates of education, fertility and income. For adults with cancer, about 50% of DALYs occurred in these same areas.
About 80% of children with cancer living in high-income countries achieved 5-year survival after diagnosis, compared with an estimated 35% to 40% of those living low, low-middle, middle SDI countries.
A lack of high-quality cancer data from developing countries served as the study’s main limitation.
“Improving childhood cancer survival will require considerable planning by policymakers to ensure well-functioning health systems capable of early diagnosis and treatment,” Force said in the release. “Estimating the years of healthy life children have lost due to cancer allows policymakers to compare the lifelong implications of childhood cancer with other diseases, potentially helping them determine the most effective way to spend limited resources and identify high-impact cancer-control planning decisions.”
Early diagnosis will help to substantially lower mortality and long-term morbidity among patients in low-income countries, which should be a goal moving forward, Charles A. Stiller, MA, MSc, of the National Cancer Registration and Analysis Service in London, wrote in an accompanying editorial.
“For the benefits of early diagnosis to be fully realized worldwide, it must be accompanied by improved diagnostic and treatment facilities with universal access,” Stiller wrote. “International collaboration will be an essential component of the necessary capacity. It is to be hoped that the present study will help to stimulate the necessary improvements, and future iterations can monitor their success.” – by John DeRosier
Disclosures: Force reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures. Stiller reports no relevant financial disclosures.