Sustainable care for children with cancer: a Lancet Oncology Commission

• Published in: The lancet oncology Vol. 21; no. 4; pp. e185 - e224
• Main Authors: Atun, Rifat, Bhakta, Nickhill, Denburg, Avram, Frazier, A Lindsay, Friedrich, Paola, Gupta, Sumit, Lam, Catherine G, Ward, Zachary J, Yeh, Jennifer M, Allemani, Claudia, Coleman, Michel P, Di Carlo, Veronica, Loucaides, Eva, Fitchett, Elizabeth, Girardi, Fabio, Horton, Susan E, Bray, Freddie, Steliarova-Foucher, Eva, Sullivan, Richard, Aitken, Joanne F, Banavali, Shripad, Binagwaho, Agnes, Alcasabas, Patricia, Antillon, Federico, Arora, Ramandeep S, Barr, Ronald D, Bouffet, Eric, Challinor, Julia, Fuentes-Alabi, Soad, Gross, Thomas, Hagander, Lars, Hoffman, Ruth I, Herrera, Cristian, Kutluk, Tezer, Marcus, Karen J, Moreira, Claude, Pritchard-Jones, Kathy, Ramirez, Oscar, Renner, Lorna, Robison, Leslie L, Shalkow, Jaime, Sung, Lillian, Yeoh, Allen, Rodriguez-Galindo, Carlos
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.04.2020; Elsevier Limited
• Subjects: Brain cancer; Business growth; Cancer; Child; Children; Clinical Medicine; Cost of Illness; Developing Countries; Disease; Disease prevention; Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi; Funding; Health care; Health Care Costs; Health Sciences; Health Services Accessibility - organization & administration; Hospitals; Humans; Hälsovetenskap; Klinisk medicin; Leukemia; Low income groups; Lymphoma; Medical and Health Sciences; Medicin och hälsovetenskap; Mortality; Neoplasms - epidemiology; Neoplasms - therapy; Oncology; Pediatrics; Pediatrik; Public Health, Global Health, Social Medicine and Epidemiology
• ISSN: 1470-2045; 1474-5488
• DOI: 10.1016/S1470-2045(20)30022-X

We estimate that there will be 13·7 million new cases of childhood cancer globally between 2020 and 2050. At current levels of health system performance (including access and referral), 6·1 million (44·9%) of these children will be undiagnosed. Between 2020 and 2050, 11·1 million children will die from cancer if no additional investments are made to improve access to health-care services or childhood cancer treatment. Of this total, 9·3 million children (84·1%) will be in low-income and lower-middle-income countries. This burden could be vastly reduced with new funding to scale up cost-effective interventions. Simultaneous comprehensive scale-up of interventions could avert 6·2 million deaths in children with cancer in this period, more than half (56·1%) of the total number of deaths otherwise projected. Taking excess mortality risk into consideration, this reduction in the number of deaths is projected to produce a gain of 318 million life-years. In addition, the global lifetime productivity gains of US$2580 billion in 2020–50 would be four times greater than the cumulative treatment costs of $594 billion, producing a net benefit of $1986 billion on the global investment: a net return of $3 for every $1 invested. In sum, the burden of childhood cancer, which has been grossly underestimated in the past, can be effectively diminished to realise massive health and economic benefits and to avert millions of needless deaths.