Sustainable care for children with cancer: a Lancet Oncology Commission

Scientists from the International Agency for Research on Cancer (IARC) contributed to a major new report that provides a comprehensive analysis of the global status of addressing childhood cancer care and outlines strategies to radically improve outcomes for children with cancer on a global scale.

The report of the Lancet Oncology Commission on Sustainable Care for Children with Cancer estimates that between 7.6 million and 13.7 million children will be diagnosed with cancer during the period 2020–2050 and that up to 11.1 million children may die from cancer during that period unless appropriate actions are taken.

The report’s authors call for the following six actions to implement effective childhood cancer services and avert more than 6 million avoidable deaths in 2020–2050: (1) incorporate childhood cancers into essential benefits packages when expanding universal health coverage; (2) develop national cancer control plans and provide predictable financing to ensure the expansion of sustainable care for children with cancer; (3) eliminate out-of-pocket expenditures for childhood cancer services, to halt abandonment of treatment; (4) expand access to effective services for childhood cancers by establishing cancer networks; (5) invest in the development of cancer registries that incorporate childhood cancers; and (6) invest in research, development, and innovation.

These actions are expected to produce significant improvements in diagnosis, management, and outcomes of children with cancer, especially in low- and middle-income countries. In such settings, there is usually a lack of knowledge about the cancer burden, underdiagnosis of childhood cancers, and unfavourable outcomes. Whereas 80% of children with cancer can be cured in high-income countries in Asia, Europe, North America, and Oceania, it is likely that only 20% are cured in low- and middle-income countries, although these statistics are mostly unavailable there.

The report’s authors also estimate that with new funding to scale up cost-effective interventions, 318 million life years could be gained in 2020–2050. The accompanying global lifetime productivity gains of US$ 2580 billion would be 4 times the predicted cumulative treatment costs.

This Lancet Oncology Commission report comes at a timely moment to support the ambitious target of the World Health Organization (WHO) Global Initiative for Childhood Cancer, which aims to increase the cure rate to 60% for all childhood cancer patients globally by 2030. Population-based cancer registration is essential for building a successful and measurable cancer control plan. The Global Initiative for Cancer Registry Development, which is led by IARC, works to transfer knowledge to assist countries in responding to the call for action on childhood cancer care.

Atun R, Bhakta N, Denburg A, Frazier AL, Friedrich P, Gupta S, et al.
Sustainable care for children with cancer: a Lancet Oncology Commission.
Lancet Oncol, Published online 30 March 2020;
https://doi.org/10.1016/S1470-2045(20)30022-X

Read the report

Read the Q&A with Dr Eva Steliarova-Foucher