Childhood cancer in India
Highlights
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Childhood cancer incidence in India is lower especially in leukaemia and CNS tumours likely due to delayed recognition with many “missed cases”.
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Childhood cancer in India is seen more frequently in boys due to gender bias in seeking care.
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Children with cancer presents late with more advanced stage with poor awareness, delayed diagnosis and treatment abandonment being major hurdles in management.
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Establishment of collaborative groups and training programs in last decades improved outlook.
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Improving accessibility, holistic support and identifying missed cases should be focus for future.
Abstract
India has made significant improvement in childhood cancer services in last few decades. However, the outcome still remains modest as compared to global standards due to significant barriers in recognition, diagnosis and cure.
Data regarding comprehensive childhood cancer burden in country is lacking due to low and urban predominant coverage of population-based cancer registry programs. The available data shows lower incidence of childhood cancer incidence especially in leukaemia and CNS tumours which may suggest poor awareness of caregivers and delayed diagnosis with many “missed cases”. Incidence data are also skewed towards male preponderance which suggests gender bias in seeking healthcare.
The childhood cancer services in India are predominantly restricted to few tertiary care centres in major cities. The outcome in major groups of cancer is complicated by delayed and more advanced stage of presentation and poor supportive care during intensive treatment. Treatment refusal and abandonment remains major hurdles.
Last few decades saw development of dedicated paediatric oncology services and training programs in the country. The development of InPOG (Indian Paediatric Oncology group) for conducting collaborative trials will lead to adoption of uniform treatment protocols suited for the country. Financial support through the government promoted health insurance and holistic support through philanthropic organizations have improved treatment adherence and outcome.
Moving forward, the focus should be on strengthening the cancer registries for capturing nationwide data, improving awareness of childhood cancer among caregivers and healthcare workers for early recognition and improving accessibility of childhood cancer care services beyond major cities.