Defeat childhood cancer, the thorn in nation’s side

Cancer is one of the leading causes of death. The World Health Organisation (WHO) says cancer killed almost 10 million people, or one in every six, in 2020.

In Kenya, cancer is the third-leading cause of death after infectious and cardiovascular diseases. A GLOBOCAN report shows Kenya had 42,116 new cancer cases and 27,092 cancer deaths reported in 2020 alone.

There are 400,000 new childhood cancer cases and more than 80 per cent of these are found in low- and middle-income countries like Kenya.

Although the national cancer registries for childhood cancer in the country have not captured all the data, GLOBOCAN estimated in 2018 that the country diagnosed about 3,200 new cases, which was an under-estimate since population statistics propose that we should be diagnosing about 6,000-7,000 yearly. 

Sadly, about half of the children with cancer in Kenya do not get a diagnosis at all!

Most adult cancers can be linked to lifestyle factors like exposure to infectious agents, alcohol or cigarette smoking, unhealthy diets, obesity and possibly environmental toxins.

However, most childhood cancers have no known risk factors with only about 5-10 per cent being associated with genetic or inherited syndromes like Downs Syndrome.

Screening of childhood cancer is of minimal value as most of the symptoms and signs of the disease are shared with other infectious illnesses.

It is, therefore, necessary, for parents and healthcare providers to maintain a high index of suspicion, especially for patients who do not improve on conventional therapy for infectious diseases, or have symptoms that persist or worsen while on treatment.

In high-income countries, the cure rate of childhood cancers is above 80 per cent, but that of low- and middle-income countries (LMICs) is still way below 20 per cent. A local study at the Moi Teaching and Referral Hospital found that only 20 per cent of children being treated for childhood cancer in Kenya would survive their diagnosis.

Dismal outcomes

We attribute the dismal outcomes of childhood cancer in our setting to late presentation, a low level of awareness of symptoms and signs by caregivers and frontline healthcare providers, weak referral systems, inadequate diagnostic and treatment facilities, and financial challenges when parents and caregivers have to pay for their health services.

Access to effective diagnosis and treatment is crucial to improving survival rates for childhood cancers in LMIC. It is important for childhood cancer to be diagnosed early because it significantly improves the outcome of treatment.

There is a need for a cross-cutting approach that takes into consideration the roles of clinicians, hospitals, insurers, researchers and policymakers in setting up adequate and effective diagnosis and treatment systems.

Indeed, there is hope for a brighter future for the children struck by cancer’s blight as long as all stakeholders act to improve the ecosystem.

Dr Karimi is a haemato-oncologist at Gertrude’s Children’s Hospital. [email protected].