Survival of patients with paediatric cancer is still extremely poor in low-income and mid-income countries, with wide variances in paediatric-cancer care and available resources noted between countries, according to the first report from the International Union Against Cancer (UICC) My Child Matters programme*, and published in the August edition of The Lancet Oncology.
Between Sept 5, 2005, and May 26, 2006, Prof Raul Ribeiro (St Jude Children's Research Hospital, Memphis, TN, USA) and colleagues, assessed the status of paediatric-oncology care and 5-year survival in ten low-income and mid-income countries receiving My Child Matters support. Face-to-face interviews with clinicians, hospital managers, health officials, and other health-care professionals were held in Bangladesh, Egypt, Honduras, Morocco, the Philippines, Senegal, Tanzania, Ukraine, Venezuela, and Vietnam to ascertain key elements of paediatric care, including survival, and to provide baseline survival data for comparison in future studies within the programme. Factors assessed in the interviews included availability of national paediatric-cancer programmes, dedicated paediatric-cancer hospital units, diagnostic resources, and anti-cancer and antibiotic drugs. To assess the accuracy and relevance of the data from this survey, findings were compared with national incidence data for paediatric cancer, obtained from population-based registries, and were also correlated with demographic, health, and socioeconomic data from global-health organisations.
Paediatric-oncology care varied substantially between countries and the number of patients reportedly receiving medical care (obtained from survey data) was different from the number predicted by the population-based incidence data. In seven of the ten countries, access to care or management of paediatric care were extremely poor. Postulated 5-year survival was: 5��% in Bangladesh, the Philippines, Senegal, Tanzania, and Vietnam; 30% in Morocco; and 40��% in Egypt, Honduras, the Ukraine, and Venezuela. Survival was also shown to be directly proportional to per capita annual total health-care expenditure, per capita gross domestic product, per capita gross national income, number of physicians and nurses per 1000 population, and annual government health-care expenditure per capita.
Prof Ribeiro concludes: "Detailed surveys can provide useful data for baseline assessment of the status of paediatric oncology, but cannot substitute for national cancer registration. Alliances between public, private, and international agencies might rapidly improve the outcome of children with cancer in these countries".
Prof Raul Ribeiro, Department of Oncology and International Outreach Program, St Jude Children's Research Hospital, Memphis, TN, USA raul.ribeiro@stjude.org
Tel : 1-901-495-3694
Notes for Editors:
The My Child Matters initiative was first launched in December, 2005, as part of the UICC's World Cancer Campaign. The awards are financially supported by Sanofi-Aventis with additional funding provided by the US National Cancer Institute. The initiative aims to improve dissemination of information about cancer in children to health professionals and the general public, to improve early diagnosis and access to care, and to strengthen support for children with cancer and their families in the developing world.
For full paper please e-mail tony.kirby@lancet.com
Journal
The Lancet Oncology