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      Global, regional, and national childhood cancer burden, 1990–2019: An analysis based on the Global Burden of Disease Study 2019

      research-article
      Author(s): a , b , 1 , a , b , 1 , a , c , 1 , d , e , f , b , a , b , a , a , b , a , a , a , b , b , g , * , a , b , *
      Publication date (Electronic):
      Journal: Journal of Advanced Research
      Publisher: Elsevier
      Keywords: DALYs, disability-adjusted life years, SDI, sociodemographic index, LMICs, low- and middle-income countries, HICs, high-income countries, GBD, Global Burden of Disease, ASRs, age-standardized rates, UIs, uncertainty intervals, APCs, Annual percentage changes, CIs, confidence intervals, ASIR, age-standardized incidence rate, ASPR, age-standardized prevalence rate, ASDR, age-standardized death rate, brain and CNS, cancer brain and central nervous system cancer, ALL, acute lymphoid leukemia, NHL, non-Hodgkin lymphoma, Childhood, Cancer, Burden, Epidemiology, Global burden of disease study

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          Graphical abstract

          Highlights

          • •

            We provided a comprehensive and the latest evaluation of the global childhood cancer burden.

          • •

            The childhood cancer burden has been decreasing globally over the last 30 years.

          • •

            Age-standardized incidence and prevalence rates of childhood cancer were more notable in higher SDI quintiles.

          • •

            Age-standardized death and disability-adjusted life year rates of childhood cancer decreased with SDI.

          • •

            Leukemia was still the most common cancer and the leading cause of death among children.

          Abstract

          Introduction

          Cancer is the leading cause of death among children.

          Objectives

          We report on the latest estimates of the burden of cancer among children at the global, regional, and national levels from 1990 to 2019.

          Methods

          Based on the Global Burden of Disease Study 2019, children’s cancer data were analyzed by sex, age, year, and location. Age-standardized rates were used to compare the burdens among regions and nations. Joinpoint analysis was applied to assess the temporal trend of the global childhood cancer burden.

          Results

          In 2019, 291,319 (95% uncertainty interval [UI], 254,239 to 331,993) new cases and 98,834 (86,124 to 113,581) deaths from childhood cancer were documented globally. Further, 8,302,464 (7,230,447 to 9,555,118) DALYs and 1,806,630 (1,567,808 to 2,089,668) prevalent cases were recorded in the same year. Age-standardized incidence and prevalence rates of childhood cancer were greatest in higher SDI settings and increased most significantly in Australasia and Southern Latin America over the last 30 years. However, although age-standardized death and DALY rates of childhood cancer have remarkably decreased in all regions since 1990, countries with a lower SDI showed the highest rates in 2019, particularly in countries in Eastern Sub-Saharan Africa. Among all cancers, leukemia has shown the largest decrease in burden since 1990. Despite this, leukemia was still the most common cancer and the leading cause of death among children in 2019, followed by brain and central nervous system cancer.

          Conclusions

          On a global scale, the childhood cancer burden has significantly fallen over the last 30 years, but is still higher in lower SDI countries. Effective interventions and collaborations among nations should be facilitated to improve healthcare among children with cancer in countries with lower SDI.

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          Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries

          Ahmedin Jemal, Lindsey A Torre, Rebecca Siegel … (2018)
          This article provides a status report on the global burden of cancer worldwide using the GLOBOCAN 2018 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer, with a focus on geographic variability across 20 world regions. There will be an estimated 18.1 million new cancer cases (17.0 million excluding nonmelanoma skin cancer) and 9.6 million cancer deaths (9.5 million excluding nonmelanoma skin cancer) in 2018. In both sexes combined, lung cancer is the most commonly diagnosed cancer (11.6% of the total cases) and the leading cause of cancer death (18.4% of the total cancer deaths), closely followed by female breast cancer (11.6%), prostate cancer (7.1%), and colorectal cancer (6.1%) for incidence and colorectal cancer (9.2%), stomach cancer (8.2%), and liver cancer (8.2%) for mortality. Lung cancer is the most frequent cancer and the leading cause of cancer death among males, followed by prostate and colorectal cancer (for incidence) and liver and stomach cancer (for mortality). Among females, breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death, followed by colorectal and lung cancer (for incidence), and vice versa (for mortality); cervical cancer ranks fourth for both incidence and mortality. The most frequently diagnosed cancer and the leading cause of cancer death, however, substantially vary across countries and within each country depending on the degree of economic development and associated social and life style factors. It is noteworthy that high-quality cancer registry data, the basis for planning and implementing evidence-based cancer control programs, are not available in most low- and middle-income countries. The Global Initiative for Cancer Registry Development is an international partnership that supports better estimation, as well as the collection and use of local data, to prioritize and evaluate national cancer control efforts. CA: A Cancer Journal for Clinicians 2018;0:1-31. © 2018 American Cancer Society.
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            Cancer Statistics, 2021

            Rebecca Siegel, Kimberly D Miller, Hannah Fuchs … (2021)
            Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths in the United States and compiles the most recent data on population-based cancer occurrence. Incidence data (through 2017) were collected by the Surveillance, Epidemiology, and End Results Program; the National Program of Cancer Registries; and the North American Association of Central Cancer Registries. Mortality data (through 2018) were collected by the National Center for Health Statistics. In 2021, 1,898,160 new cancer cases and 608,570 cancer deaths are projected to occur in the United States. After increasing for most of the 20th century, the cancer death rate has fallen continuously from its peak in 1991 through 2018, for a total decline of 31%, because of reductions in smoking and improvements in early detection and treatment. This translates to 3.2 million fewer cancer deaths than would have occurred if peak rates had persisted. Long-term declines in mortality for the 4 leading cancers have halted for prostate cancer and slowed for breast and colorectal cancers, but accelerated for lung cancer, which accounted for almost one-half of the total mortality decline from 2014 to 2018. The pace of the annual decline in lung cancer mortality doubled from 3.1% during 2009 through 2013 to 5.5% during 2014 through 2018 in men, from 1.8% to 4.4% in women, and from 2.4% to 5% overall. This trend coincides with steady declines in incidence (2.2%-2.3%) but rapid gains in survival specifically for nonsmall cell lung cancer (NSCLC). For example, NSCLC 2-year relative survival increased from 34% for persons diagnosed during 2009 through 2010 to 42% during 2015 through 2016, including absolute increases of 5% to 6% for every stage of diagnosis; survival for small cell lung cancer remained at 14% to 15%. Improved treatment accelerated progress against lung cancer and drove a record drop in overall cancer mortality, despite slowing momentum for other common cancers.
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              Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

              Theo Vos, Stephen S Lim, Cristiana Abbafati … (2023)
              Summary Background In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and development investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding Bill & Melinda Gates Foundation.
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                Author and article information

                Contributors
                Jun Lyu
                Zhijun Dai
                Journal
                Journal ID (nlm-ta): J Adv Res
                Journal ID (iso-abbrev): J Adv Res
                Title: Journal of Advanced Research
                Publisher: Elsevier
                ISSN (Print): 2090-1232
                ISSN (Electronic): 2090-1224
                Publication date PMC-release: 11 June 2022
                Publication date Collection: September 2022
                Publication date (Electronic): 11 June 2022
                Volume: 40
                Pages: 233-247
                Affiliations
                [a ]Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
                [b ]Department of Oncology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
                [c ]Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
                [d ]Celilo Cancer Center, Oregon Health Science Center affiliated Mid-Columbia medical center, The Dalles, OR, USA
                [e ]Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
                [f ]Department of Medical Oncology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
                [g ]Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou 510632, China
                Author notes
                [* ]Corresponding authors at: Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China (Zhijun Dai). lyujun2019@ 123456163.com dzj0911@ 123456126.com
                [1]

                Y W, YJ D and BJ W contributed equally to this work.

                Article
                Publisher Item ID: S2090-1232(22)00127-8
                DOI: 10.1016/j.jare.2022.06.001
                PMC ID: 9481947
                PubMed ID: 35700919
                SO-VID: b31e489a-b364-48f4-9c6f-1e5a6655dab8
                Copyright © © 2022 Published by Elsevier BV on behalf of Cairo University.
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 23 August 2021
                Date revision received : 25 April 2022
                Date accepted : 3 June 2022
                Categories
                Subject: Original Article

                Keywords: dalys, disability-adjusted life years,sdi, sociodemographic index,lmics, low- and middle-income countries,hics, high-income countries,gbd, global burden of disease,asrs, age-standardized rates,uis, uncertainty intervals,apcs, annual percentage changes,cis, confidence intervals,asir, age-standardized incidence rate,aspr, age-standardized prevalence rate,asdr, age-standardized death rate,brain and cns, cancer brain and central nervous system cancer,all, acute lymphoid leukemia,nhl, non-hodgkin lymphoma,childhood,cancer,burden,epidemiology,global burden of disease study
                Data availability:
                Keywords: dalys, disability-adjusted life years, sdi, sociodemographic index, lmics, low- and middle-income countries, hics, high-income countries, gbd, global burden of disease, asrs, age-standardized rates, uis, uncertainty intervals, apcs, annual percentage changes, cis, confidence intervals, asir, age-standardized incidence rate, aspr, age-standardized prevalence rate, asdr, age-standardized death rate, brain and cns, cancer brain and central nervous system cancer, all, acute lymphoid leukemia, nhl, non-hodgkin lymphoma, childhood, cancer, burden, epidemiology, global burden of disease study

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