Childhood cancers were the eight leading cause of death in children globally — killing more than common infectious conditions such as measles, tuberculosis, and HIV/AIDS. With outcomes largely determined by resource availability, 94% of the deaths in 2023 were concentrated in low and middle income countries, according to the atest findings from the Global Burden of Disease (GBD) 2023 study published today in The Lancet.

There were 377,000 new cases of childhood cancer and 144,000 deaths worldwide in 2023, according to the research.

In India, childhood cancers were the tenth leading cause of deaths among children, killing 17,000 in 2023, according to the study. “Despite this childhood cancer is not included in India’s national cancer control planning,”Dr Venkatraman Radhakrishnan, Professor of Medical Oncology at the Cancer Institute (W.I.A), Adyar, Chennai, said.

The national programme screens only for the three most common forms of cancers seen in men and women — oral, cervical, and breast.

While mortality declined globally, the estimates show that the children in low and middle-income countries face the most severe consequences. South Asia accounts for 20.5 percent or one in five global child cancer deaths. Not only that, the report shows there was a 16.9 percent increase in childhood cancer deaths from 1990 to 2023.

The number of new cases of childhood cancers has been relatively stable globally, while the number of deaths have decreased by 27%. These cancers, however, were concentrated in the low and middle income countries. The estimates show that 85% of new cases, 94% of deaths, and 94% of disability-adjusted life years (DALYs) in 2023 were from these countries.

DALYs measure the total years of healthy life lost by examining the years lost from premature death and years lived with disability.

“The study highlights the substantial burden of childhood cancer in low and middle-income countries. Most of these deaths are preventable. Addressing this requires urgent inclusion of childhood cancer in national cancer control plans, alongside investment in early diagnosis, access to essential treatment, strong supportive care, and robust cancer registries to guide planning and improve outcomes,” Dr Radhakrishnan said.

Lisa Force, lead author from the Institute for Health Metrics and Evaluation at the University of Washington School of Medicine, added: “While outcomes for many childhood cancers have improved in high-income countries, these gains have not been equitably shared. The vast majority of children with cancer live in low- and middle-income countries, where delays in diagnosis, lack of access to essential cancer treatment, and other health system limitations and barriers to care can contribute to disparities in childhood cancer burden.”

To address this inequality, there is a need for expanded investment in cancer control systems in the low and middle income countries, including referral systems that support timely diagnosis, workforce training, access to chemotherapy, surgery and radiotherapy, as well as stronger cancer registration and surveillance systems.

Study authors note that information on childhood cancer burden is crucial for effective cancer policy planning. “Unfortunately, observed paediatric cancer data are not available in every country, and previous global burden estimates have not discretely reported several common cancers of childhood. We aimed to inform efforts to address childhood cancer burden globally by analysing …GBD 2023,” authors of the study said.