Childhood Cancer: 10th Leading Cause of Death Among Kids in India

A recent Global Burden of Disease (GBD) 2023 study, published in the prestigious medical journal The Lancet, has brought to light a critical public health concern in India: cancer is the 10th leading cause of death among children in the country. This significant finding, reported by The Indian Express, underscores the urgent need for focused attention on pediatric oncology in India. The study reveals that approximately 17,000 children in India succumbed to cancer in 2023 alone. Globally, the GBD 2023 study identifies cancer as the eighth leading cause of death for children, surpassing infectious diseases like measles, tuberculosis, and HIV/AIDS. The disparity in outcomes is largely dictated by resource availability, with children in low- and middle-income countries (LMICs) disproportionately affected. These nations accounted for a staggering 85% of new childhood cancer cases, 94% of childhood cancer deaths, and 94% of disability-adjusted life years (DALYs) worldwide in 2023. The burden on South Asia, including India, is particularly severe, with the region accounting for 20.5% of the global childhood cancer deaths. While there has been a global decline of 27% in childhood cancer deaths since 1990, South Asia only saw a 16.9% reduction during the same period, indicating a slower progress in this critical region. Dr. Venkatraman Radhakrishnan, Professor of Medical Oncology at the Cancer Institute in Adyar, Chennai, expressed deep concern over the study's findings, highlighting that despite the significant mortality figures, childhood cancer is currently not integrated into India's national cancer control planning. India's existing national programme primarily focuses on screening for oral, cervical, and breast cancers, which are prevalent among adults. This oversight means that a dedicated policy and strategic framework for addressing childhood cancers are largely absent, leaving a critical gap in public health efforts. Childhood cancers present distinct challenges compared to adult cancers. They are rarely linked to lifestyle factors, often stemming from genetic changes that occur early in life. The most prevalent types of childhood cancers globally, and in India, include leukemias, brain and central nervous system (CNS) cancers, and non-Hodgkin lymphoma. The challenges in India extend beyond policy. Limited awareness among parents and healthcare professionals often leads to delayed diagnoses, with children frequently presenting in advanced stages of the disease. Access to specialized pediatric oncology care is also a major hurdle, particularly in rural areas, where nearly 70% of India's population resides but most specialized cancer centers are located in urban tertiary hospitals. The financial burden of treatment, which can range from ₹1–7 lakh per case, further exacerbates the problem, often leading to treatment abandonment. Workforce and infrastructure limitations, including a shortage of specialized multidisciplinary care teams, also contribute to poorer outcomes. Older studies and reports from India's National Cancer Registry Programme (NCRP) consistently indicate the significant incidence of childhood cancers. For instance, according to the NCRP, childhood cancers (0-14 years) constitute approximately 4.0% of all cancer cases in India, with an estimated 52,000 new cases annually. Incidence rates have been observed to be rising over the past decade, though regional disparities in diagnosis and reporting suggest potential underdiagnosis in certain areas. In 2010, an estimated 13,700 childhood cancer deaths were reported in India. Experts emphasize the need for urgent inclusion of childhood cancer in national health policies. This would necessitate investment in early diagnosis mechanisms, ensuring access to essential treatments, establishing strong supportive care systems, and maintaining robust cancer registries to guide planning and improve overall outcomes. Addressing these systemic issues is crucial to improving the survival rates for Indian children battling cancer, bringing them closer to the 80-90% survival rates seen in high-income countries, compared to the 20-30% in lower-income regions. This news highlights that while overall cancer deaths globally have decreased, the disparities in LMICs, especially India, remain substantial. The GBD 2023 study serves as a critical call to action for policymakers and healthcare providers in India to prioritize childhood cancer care and integrate it effectively into national health strategies.

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