New Delhi: An AIIMS New Delhi-led review has brought together three decades of published childhood cancer survival evidence in India, providing policy makers the country’s first consolidated picture of outcomes across major childhood cancers.
The researchers screened 6,802 published articles up to December 2023 and included 182 studies from treatment centres across the country, covering 22,886 children, to share insights that promise to help policy makers identify gaps and strengthen accountability in India’s fight against childhood cancer.
Published in JCO Global Oncology, the study was led by Sameer Bakhshi and colleagues at AIIMS New Delhi, in partnership with CanKids…KidsCan and international collaborators, including the World Health Organisation (WHO) and St. Jude Children’s Research Hospital in the US.
Bakhshi said, “We hope this work will stimulate stronger cancer registries, multicentre collaborative research and standardised outcome reporting, enabling India to measure progress more effectively and continuously improve outcomes for children with cancer.”
The exploratory pooled estimates showed substantial variation in survival across childhood cancers.
Five-year overall survival was estimated at 67.1 per cent for acute lymphoblastic leukaemia (blood cancer), 93.1 per cent for Hodgkin lymphoma (swollen lymph nodes), 76.8 per cent for retinoblastoma (eye cancer) and 78.8 per cent for Wilms tumour (kidney tumour).
Three-year overall survival was estimated at 60.9 per cent for acute myeloid leukaemia (blood cancer), 97 per cent for chronic myeloid leukaemia (blood cancer), 56.9 per cent for neuroblastoma (cancer of nerve cells) and 60.3 per cent for osteosarcoma (blood cancer).
The review also reported a median overall survival of 43.9 months for medulloblastoma (brain tumour) and 21.2 months for Ewing sarcoma (bone cancer). Within retinoblastoma, however, outcomes were significantly poorer for children with extraocular disease, with a pooled two-year overall survival of 44.9 per cent.
“The importance of this study goes beyond the individual survival estimates. India’s driving 2030 goals, aligned with the UNGA 80 call, the WHO Global Initiative for Childhood Cancer and Universal Health Coverage, are 100 per cent access to care, 100 per cent financial protection and at least 60 per cent survival,” CanKids Founder-Chairman Poonam Bagai said.
The collective aim is that efforts of government agencies and voluntary organisations must ultimately translate into better survival.
“Without survival evidence baseline, how could we measure progress, identify where children were still being left behind, or determine where treatment quality, supportive care, continuity of care and financial protection needed urgent strengthening,” she added.
Vinod Paul, former Member (Health) at NITI Aayog, said, “This landmark study by the AIIMS New Delhi team, in partnership with CanKids…KidsCan and national and international collaborators, gives India an important evidence base for childhood cancer survival.”
He added, “A patient-centred system must measure not only whether a child reaches treatment, but whether the child remains in care, completes treatment, survives and thrives.”
“This evidence can help government, clinicians, researchers and civil society identify gaps, strengthen accountability and accelerate equitable progress in India’s fight against childhood cancer,” Paul said.
Sameer Bakhshi, Professor and Head of Department of Medical Oncology at AIIMS New Delhi, and corresponding author of the study, said, “This review is the first comprehensive synthesis of published childhood cancer survival evidence from India.”
“By systematically bringing together three decades of data from centres across the country, it establishes an important evidence base for understanding survival across different childhood cancers while identifying critical gaps in knowledge,” he added.
(IANS)
