Cancer Registries and the Descriptive Epidemiology of Pediatric Cancer in Low-and Middle-Income Countries

Abstract

The treatment of pediatric cancer, once an unaffordable luxury, has become of increasing importance in low- and middle-income countries (LMIC) as deaths due to communicable disease and neonatal mortality decline. Cancer is now one of the top five causes of death during childhood in most countries in the world. When cancer is added to the public health agenda of a country, a necessary component of a National Cancer Plan is the establishment of a population-based cancer registry. Population-based cancer registries serve as the basis for cancer prevention, cancer planning, cancer treatment, and cancer research. In this chapter we review the key differences between a hospital-based and a population-based cancer registry and the essential elements necessary to establish a valid representative population-based cancer registry. We then present the most current data on the epidemiology of childhood cancer globally, derived from the analysis of GLOBOCAN 2008, the most recent estimates of global cancer incidence by the International Agency for Cancer Research. The data available reveal striking differences in the rates of pediatric cancer by region of the world, for instance, the importance of non-Hodgkin lymphoma in the midst of the HIV epidemic in Africa, and the high rates of liver cancer in children in Asia. Expanding the coverage of children included in cancer registries globally will allow for better understanding of the epidemiology of childhood cancer, priorities for prevention, and opportunities to improve treatment outcomes.