Estimation of childhood cancer incidence, prevalence, mortality and registration (0-14 years) in the WHO Eastern Mediterranean Region: an analysis of GLOBOCAN 2020 data

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Background

There is little evidence on the burden of childhood cancer in the WHO Eastern Mediterranean Region (EMR). Our aim was to provide an estimate of the burden of childhood cancer in the EMR, to examine the relationship between age-standardized mortality rate and income level (gross domestic product [GDP] per capita) and reflect on the current state of recording childhood cancer in the EMR.

Methods

Using GLOBOCAN 2020 data from the Cancer Surveillance Unit of the International Agency for Research on Cancer, we extracted data on the incidence, prevalence and mortality of cancer in children (aged 0 to 14 years) for 22 countries in the EMR, the EMR as a whole, and other WHO regions, and classified by major types of cancer. Childhood cancers have been classified according to the 10th revision of the International Classification of Diseases. We also searched MEDLINE, Google Scholar and gray literature between May 17 and August 2, 2021 for articles and reports in English on the status of childhood cancer registration in the EMR . We then examined the relationship between age-standardized mortality rate and GDP per capita for the 22 RMS countries.

Results

The estimated total number of incident childhood cancer cases in the EMR was 23,847 in 2020, with an age-standardized incidence rate of 10 1 per 100,000 children at risk, ranging from 7 3 per 100 000 children at risk in Pakistan to 13·8 per 100,000 children at risk in Iran. The estimated number of incident cases was 7451 (age-standardized incidence rate 3 10 per 100,000 children at risk) for leukemia, 3006 (1 30 per 100,000 children at risk) for brain tumors and CNS, 2,222 (0 92 per 100,000 children at risk) for non-Hodgkin lymphoma, 1,569 (0.67 per 100,000 children at risk) for kidney cancers and 1,420 (0.58 per 100,000 children at risk) for Hodgkin lymphoma. In 2020, the estimated total number of childhood cancer deaths in the EMR was 10,535, with an age-standardized mortality rate of 4.4 (per 100,000 children at risk, ranging from 0.8 per 100 000 children at risk in Qatar to 7.2 per 100,000 children at risk in Somalia A negative correlation was found between GDP per capita (income level) and mortality rates (r=–0 77, p

Interpretation

Given the variable quality and coverage of cancer registries in EMR countries, these results are likely to be underestimated. Nevertheless, these data, particularly the high mortality rates, reflect the need for effective national childhood cancer control plans, in line with the WHO Global Initiative for Childhood Cancer, in order to improve survival.

Funding

Friends of cancer patients.

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