Recent findings indicate that cancer has emerged as a significant cause of mortality among children in India, ranking among the top ten causes of death. This alarming trend is highlighted in a study published in The Lancet, which underscores the rising public health challenge of childhood cancers. The data sourced from the Global Burden of Diseases, 2023, reveals that while infectious diseases are on the decline, non-communicable diseases like cancer are increasingly threatening child survival.

In particular, the Indian Council of Medical Research’s National Centre for Disease Informatics and Research (ICMR-NCDIR) reported that childhood cancers constituted approximately three to five per cent of all cancers in India in 2022. Each year, the nation witnesses around 50,000 to 60,000 new cases among children aged 0 to 14 years, positioning India as one of the countries with the highest burden of childhood cancer globally.

Globally, there were 377,000 new cases of childhood cancer and 144,000 deaths reported in 2023, according to the same study. These figures highlight the urgent need for enhanced awareness and improved healthcare measures to address this growing issue in India.

Challenges in Detection and Treatment

Among the various forms of childhood cancers, leukaemias, commonly known as blood cancers, are the most prevalent in India, followed by lymphomas and central nervous system tumours. Together, they account for a significant portion of paediatric cancer cases. Incidence rates tend to vary by region, with urban areas like Delhi reporting higher figures, attributed to more effective detection and reporting mechanisms.

Experts suggest that the actual number of cases could be higher due to many factors, including inadequate cancer registration and limited access to diagnostic services, particularly in rural and underserved communities. This often leads to late diagnoses, hindering treatment effectiveness. An oncologist from the Delhi State Cancer Institute noted that symptoms of childhood cancers, such as fatigue or unexplained weight loss, can resemble common illnesses, complicating early detection.

The ICMR’s factsheet from 2022 indicates that many children arrive at specialised cancer facilities only in advanced disease stages, complicating treatment options and reducing chances of recovery. Access to paediatric oncology services heavily favours urban centres, necessitating families from smaller towns or rural regions to undertake long journeys. This geographical disparity exacerbates treatment delays, particularly for economically disadvantaged families.

Financial considerations also present significant barriers. Even with subsidised treatments, ancillary expenses such as travel, accommodation, and lost wages can pose challenges. Consequently, treatment abandonment remains a serious issue, adversely impacting survival rates.

Disparities in Survival Rates

While the global survival rate for childhood cancers exceeds 80 per cent in high-income nations, outcomes in India are improving but remain inconsistent. The ICMR report emphasises that survival rates can differ greatly based on factors such as types of cancer, stages at diagnosis, and treatment facilities. Leading centres in India have documented survival rates similar to those in developed countries for specific cancers, notably acute lymphoblastic leukaemia.

However, these positive outcomes are not uniformly representative across the nation, revealing systemic inequalities. Children treated in urban centres characterised by comprehensive resources and multidisciplinary teams generally have better prognoses than those receiving care in resource-poor environments.

Moreover, improving survival rates has introduced new concerns, particularly regarding long-term follow-up care for survivors. Issues related to late effects of treatment—including the risk of secondary cancers and developmental challenges—are not adequately addressed within India’s current healthcare framework. The ICMR report advocates for a dedicated focus on paediatric cancers, highlighting the necessity for specialised facilities, trained personnel, and robust referral networks alongside an expansion of population-based cancer registries to enhance data collection and reliability.

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