Don’t overlook cancer among children

Paediatric cancer occupies a nebulous place in India’s public health priorities. India’s core national cancer-control priorities focus largely on adult variants

India’s paediatric cancer burden, underscored by the latest findings from the Global Burden of Disease (GBD) 2023 study published in Lancet Oncology, reveals a landscape marked by persistent gaps. Cancer is now the tenth leading cause of death among children, with an estimated 17,000 deaths in 2023, even as global mortality has steadily declined. Studies estimate that there are roughly between 50,000 and 75,000 new paediatric cancer cases each year in India, though the true figure may be higher –cancer registries cover barely 10–15 per cent of the population. Set against the global picture — low- and middle-income countries account for the overwhelming majority of childhood cancer deaths — India’s experience reflects both its demographic weight and its uneven health infrastructure. Many childhood cancers are among the most treatable of malignancies, yet survival outcomes continue to remain uneven.

Paediatric cancer occupies a nebulous place in public health priorities. India’s core national cancer-control priorities focus largely on adult variants. This omission is compounded by weak surveillance systems and significant underdiagnosis. Primary care systems are not uniformly equipped to recognise early warning signs, and specialist services remain concentrated in urban centres, leading to delayed diagnosis, referrals and treatment. Inequalities, especially financial and logistical, continue to shape outcomes. As a result, many children are brought in when the disease has already progressed to an advanced stage; a sizeable section discontinues treatment before completion.

Yet, the evidence also points, rather cautiously, towards possibilities. Where timely diagnosis and uninterrupted treatment are available, survival rates, especially for cancers such as leukaemia, have improved significantly. This suggests that India’s childhood cancer burden is not intractable. The next phase must focus on scaling up — embedding paediatric oncology in national cancer-control strategies, expanding decentralised treatment capacity, training frontline providers to recognise early signs, and building robust data systems, alongside research into genetic and environmental determinants. India’s alignment with global efforts, including WHO’s childhood cancer initiative, offers a guiding framework. Policy must now focus on translating incremental gains into equitable outcomes.