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https://ecancer.org/en/journal/article/1993-global-initiative-for-childhood-six-indexed-cancers-how-are-we-faring-in-nigeria

Year: 2025

Type: article

Abstract: Background: WHO's Global Initiative for Childhood Cancer (GICC) aims to increase global survival of childhood cancers to 60% by the year 2030 with a focus on six index cancers.However, there is no nationally representative epidemiologic data on these index cancers in Nigeria.Aim: To describe the distribution, outcomes and determinants of GICC six-indexed cancer in Nigeria.Methodology: A multi-centre ambi-directional cohort study of children was done in children <19 years diagnosed with any of acute lymphoblastic leukaemia (ALL), Wilms tumour (WT), retinoblastoma (RB), Hodgkin lymphoma (HL), Burkitt lymphoma (BL) or low-grade glioma (LGG).Seven centres in the six geopolitical zones of the country participated.A 2-year study with 18 months of retrospective data collection (January 2022-June 2023) and follow up of subjects was done for 6 months (July-December 2023).Results: A total number of 213 subjects were enrolled and ALL (n = 72;33.8%),WT (n = 57; 26.8%), RB (n = 52; 24.4%), BL (n = 17; 8.0%), HL (n = 13; 6.1%) and LGG (n = 2; 0.9%) accounted for the disease pattern.Median age at diagnosis was 5 years (51.6%).Mortality rate was 32.4% and treatment abandonment occurred in 37.6% of subjects.Treatment-related mortalities (TRMs) were 37.7% with infection and haemorrhage the commonest specific causes of TRM (36.1% and 42.5%).Only 7/95 (7%) of subjects with WT and RB stage III and IV benefited from RT.The most common reasons for non-RT were lack of funds (29%), lack of access to RT (54%) and lack of physicians' referral (11%).Only 10 (4.3%) of subjects were enrolled in a health insurance scheme.Independent risk factor for mortality was advanced disease stage (p = <0.001).Amongst the mortalities, 36% died within the first 3 months of diagnosis.Conclusion: Treatment abandonment, mortality and TRM are high in Nigeria.To attain the GICC goal, there is a need to educate physician on treatment protocol, ensure availability of supportive care, health insurance, RT and tackle late presentation.

Source: ecancermedicalscience

DOI: 10.3332/ecancer.2025.1993