Global Initiative on Childhood Cancer.
Childhood cancer
Cancer is a leading cause of death for children and adolescents. The likelihood of surviving a diagnosis of childhood cancer depends on the country in which the child lives; in high-income countries, more than 80% of children with cancer are cured, but in many low- and middle-income countries (LMICs) less than 30% are cured.
Although childhood cancer cannot generally be prevented or identified through screening, most types of childhood cancer can be cured with generic medicines and other forms of treatment, including surgery and radiotherapy.
The reasons for lower survival rates in LMICs include delay in diagnosis, an inability to obtain an accurate diagnosis, inaccessible therapy, abandonment of treatment, death from toxicity (side effects) and avoidable relapse. Improving access to childhood cancer care, including to essential medicines and technologies, is highly cost-effective, feasible and can improve survival in all income settings.
Childhood cancer data systems are needed to drive continuous improvements in the quality of care, and to inform policy decisions.
Cancer occurs in people of all ages and can affect any part of the body. It begins with genetic change in single cells, that can then grow into a mass (or tumour), invade other parts of the body and cause harm and death if left untreated. Unlike cancer in adults, most childhood cancers do not have a known cause. Many studies have sought to identify the causes of childhood cancer, but very few cancers in children are caused by environmental or lifestyle factors. Cancer prevention efforts in children should focus on behaviours that will prevent the child from developing preventable cancer as an adult.
Some chronic infections, such as HIV, Epstein-Barr virus and malaria, are risk factors for childhood cancer. They are particularly relevant in LMICs. Other infections can increase a child’s risk of developing cancer as an adult, so it is important to be vaccinated (against hepatitis B to help prevent liver cancer and against human papillomavirus to help prevent cervical cancer) and to other pursue other methods such as early detection and treatment of chronic infections that can lead to cancer.
Current data suggest that approximately 10% of all children with cancer have a predisposition because of genetic factors. Further research is needed to identify factors impacting cancer development in children.
In 2018, WHO launched, with the support of St. Jude Children’s Research Hospital, the Global Initiative for Childhood Cancer (Global Initiative), to provide leadership and technical assistance to governments to support them in building and sustaining high-quality childhood cancer programmes. The goal is to achieve at least 60% survival for all children with cancer by 2030. This represents an approximate doubling of the current cure rate and will save an additional 1 million lives over the next decade.
The CureAll framework and its accompanying technical package have been developed to support implementation of the Initiative. The package helps governments and other stakeholders assess current capacity, set priorities, generate investment cases, develop evidence-based standards of care and monitor progress.
In December 2021, WHO and St Jude Children’s Research Hospital launched the Global Platform for Access to Childhood Cancer Medicines (Global Platform), the first of its kind, to provide an uninterrupted supply of quality-assured childhood cancer medicines with end-to-end support from selecting to dispensing medicines according to best possible care standards. The Global Platform synergizes with the Global Initiative, with activities implemented through this new effort expected to contribute substantially to the achievement of the initiative’s goals.
