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Cancer is a major cause of death for children and adolescents under the age of 19. With thousands diagnosed of cancers that cannot be primarily preventable or screened, the survival rate after diagnosis differs greatly between high-income and low or middle-income countries. Each year, nearly 400, 000 children and adolescents are diagnosed with cancer.

Like adults, cancer in children can occur in any part of the body but it is very rare and the majority of childhood cancers have unknown causes. From research, it has been revealed that genetics plays a significant role in increasing the risk of developing cancer in children. Approximately 10% of all children with cancer have a genetic predisposition. Only a few kinds of childhood cancers are caused by environmental (exposure to radiation and chemicals) and lifestyle factors or the ingestion of the hormone diethylstilbestrol during pregnancy; a treatment which has long been discontinued.

cancers in children
Credit 2: Children’s Cancer and Leukemia Group

Cancers often begin with genetic changes that cause cells to grow out of control. These growths known as tumours can expand and invade other parts of the body and cause death if left untreated. Some severe and chronic infections are risk factors for cancer in children and adolescents. For example, malaria, HIV and Epstein-Barr virus have been known to increase the risk of developing cancer as a child or later as an adult.

The pattern of childhood cancer varies considerably from people of other ages. There are several types of cancers that occur almost exclusively in children and there are other types of cancers that are extremely rare in children e.g., breast, lung, colon and rectal cancer in children is rare.

cancer atlas
Credit 3: Cancer Atlas- The American Cancer Society. Percentage (%) of the population in which the frequency of cancer is measured on each continent in children and adolescents.

In high-income countries, 80% of children diagnosed with cancer are cured or survive five years after diagnosis but in many low and middle-income countries, an estimated 15% – 45% of children are cured; the chances of survival are much lower. Inability to obtain an accurate and timely diagnosis, inaccessible therapy, lack of access to essential medicines and technologies are often obstacles to increased survival rate.

According to The Pediatric Oncology Resource Center (www.ped-onc.org), a number of cancer symptoms in children can be described using the acronym CHILDCANCER

  • Continued, unexplained weight loss
  • Headaches, often with morning vomiting
  • Increased swelling or persistent pain in the bones, joints, back, or legs
  • Lump or mass, mostly in the abdomen, neck, chest, pelvis or armpits
  • Development of excessive bruising, bleeding or rash
  • Constant, frequent or persistent infections
  • A whitish colour behind the pupil
  • Nausea that persists or vomiting with nausea
  • Constant tiredness or noticeable paleness
  • Eye or vision changes that occur suddenly and persist
  • Recurring or persistent fevers of unknown cause or origin

Though childhood cancers are generally not preventable or identified through screening, improving the outcomes of childhood and adolescent cancers despite obstacles is largely dependent on early diagnosis, treatment and oftentimes, palliative care.

The most effective strategy to reduce the burden of cancer in children and adolescents and increase chances of survival is focusing on timely, accurate diagnosis followed by appropriate therapy and support (family and child).

Because childhood cancer is associated with a wide range of warning symptoms, they can be identified by family members and trained healthcare providers. If the diagnosis is made accurately, the disease is more likely to respond to appropriate treatment and yield greater chances of survival, less suffering, less intensive and expensive treatment. Early and correct diagnosis improves survival for many types of childhood cancer and is also essential for treatment.

Family awareness, access to care and treatment are a few of the key components to ensuring good survival rate and clinical outcome.

Please contact or visit the nearest primary healthcare centre or childhood cancer association for more information. Together, we can create a cancer-free future for children and adolescents around the world.

References

Steliarova-Foucher E, Colombet M, Ries LAG, et al (2017). ‘International incidence of childhood cancer’, 2001-10: a population-based registry

study. Lancet Oncol;18(6):719-731.

Gupta S, Howard SC, Hunger SP, et al. ‘Treating Childhood Cancer in Low- and Middle-Income Countries. In: Disease Control Priorities’, volume 3. available at: http://dcp-3.org/chapter/900/treating-childhood-cancerslow-and-middle-income-countries.

Howard SC, Zaidi A, Cao X, et al (2018). ‘The My Child Matters programme: effect of public-private partnerships on paediatric cancer care in low income and middle-income countries’, Lancet Oncol. ;19(5):e252-e266.

Lam CG, Howard SC, Bouffet E, Pritchard-Jones K. (2019). ‘Science and Health for all children with cancer’, Science; 363 (6432):1182-1186. Doi:10,1126/science. aaw4892.

The American Society of Clinical Oncology. Childhood cancer. 2019. www.cancer.net/cancer-types/childhood-cancers/view-all-pages

Zhang J, Walsh MF, Wu G, Edmonson MN, Gruber TA, et al (2015). ‘Germline

Mutations in Predisposition Genes in Pediatric Cancer’, N Engl J Med.;373(24):2336-2346.