New policies to address the global burden of childhood cancers

Institute of Cancer Policy, King's Health Partners Integrated Cancer Centre, London, UK. Electronic address: .
The Lancet Oncology (Impact Factor: 24.73). 03/2013; 14(3):e125-35. DOI: 10.1016/S1470-2045(13)70007-X
Source: PubMed

ABSTRACT Childhood cancer is a major global health issue. Every year, almost 100 000 children die from cancer before the age of 15 years, more than 90% of them in resource-limited countries. Here, we review the key policy issues for the delivery of better care, research, and education of professionals and patients. We present a key list of time-limited proposals focusing on change to health systems and research and development. These include sector and system reforms to make care affordable to all, policies to promote growth of civil society around both cancer and Millennium Development Goals, major improvements to public health services (particularly the introduction of national cancer plans), improved career development, and increased remuneration of specialist health-care workers and government support for childhood cancer registries. Research and development proposals focus on sustainable funding, the establishment of more research networks, and clinical research specifically targeted at the needs of low-income and middle-income countries. Finally, we present proposals to address the need for clinical trial innovation, the complex dichotomy of regulations, and the threats to the availability of data for childhood cancers.

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    ABSTRACT: Background All the children registered at the National Council for the Prevention and Treatment of Childhood Cancer were analyzed. The rationale for this Federal Government Council is to financially support the treatment of all children registered into this system. All patients are within a network of 55 public certified hospitals nationwide. Methods In the current study, data from 2007 to 2012 are presented for all patients (0–18 years) with a pathological diagnosis of leukemia, lymphoma and solid tumors. The parameters analyzed were prevalence, incidence, mortality, and abandonment rate. Results A diagnosis of cancer was documented in 14,178 children. The incidence was of 156.9/million/year (2012). The median age was 4.9. The most common childhood cancer is leukemia, which occurs in 49.8% of patients (2007–2012); and has an incidence rate of 78.1/million/year (2012). The national mortality rate was 5.3/100,000 in 2012, however in the group between 15 to 18 years it reaches a level of 8.6. Conclusions The study demonstrates that there is a high incidence of childhood cancer in Mexico. In particular, the results reveal an elevated incidence and prevalence of leukemia especially from 0 to 4 years. Only 4.7% of these patients abandoned treatment. The clinical outcome for all of the children studied improved since the establishment of this national program.
    BMC Cancer 10/2014; 14(1):790. DOI:10.1186/1471-2407-14-790 · 3.32 Impact Factor
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    ABSTRACT: Cure rates for pediatric acute lymphoblastic leukemia differ markedly in higher- and lower-income countries due to disparate hospital infrastructure and resources. Where means are limited, treatment-related mortality is higher and compliance may be suboptimal. Upfront risk assignment is aimed at individualizing therapy according to presenting features in order to avoid over- or under-treatment. However, the necessary technical resources and expertise are not always readily available. The authors provide suggestions for management of childhood acute lymphoblastic leukemia in developing nations. To improve patient care locally, the authors recommend that communication technology be used to sustain partnerships between sponsoring and partner pediatric oncology programs. The aims of these collaborations should be to prioritize resources, identify existing problems and reduce treatment intensity and hence treatment-related morbidity and mortality in patients at lower risk of relapse.
    Expert Review of Hematology 08/2014; 7(5). DOI:10.1586/17474086.2014.949233 · 2.14 Impact Factor
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    ABSTRACT: Acute lymphoblastic leukemia is the most common pediatric cancer. The cure rate of this disease is over 80% in developed countries utilizing protocols with very tolerable toxicity. Several factors contributed to this success, including the implementation of large collaborative clinical trials and the better understanding of disease biology allowing for risk-stratified treatment. We will review the current state of the treatment of acute lymphoblastic leukemia in low-income and medium-income countries.
    Current Opinion in Oncology 09/2014; 26(6). DOI:10.1097/CCO.0000000000000125 · 3.76 Impact Factor


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May 30, 2014