The global burden of childhood and adolescent cancer in 2017: an analysis of the Global Burden of Disease Study 2017
Authors: Lisa M. Force, Ibrahim Abdollahpour, Shailesh M Advani, Dominic Agius, Elham Ahmadian, Fares Alahdab, Tahiya Alam, Animut Alebel, Vahid Alipour, Christine A. Allen, Amir Almasi-Hashiani, Elysia M Alvarez, Saeed Amini, Yaw Ampem Amoako, Nahla Hamed Anber, Jalal Arabloo, Al Artaman, Suleman Atique, Ashish Awasthi, Mojtaba Bagherzadeh, Huda Basaleem, Eyasu Tamru Bekru, Ali Bijani, Kassawmar Angaw Bogale, Mate Car, Félix Carvalho, Clara Castro, Ferrán Catalá-López, Dinh-Toi Chu, Vera M Costa, Amira Hamed Darwish, Feleke Mekonnen Demeke, Asmamaw Bizuneh Demis, Gebre Teklemariam Demoz, Samath Dhamminda Dharmaratne, Huyen Phuc Do, Linh Phuong Doan, Manisha Dubey, Aziz Eftekhari, Ziad El-Khatib, Mohammad Hassan Emamian, Mahdieh Abbasalizad Farhangi, Eduarda Fernandes, Florian Fischer, Reza Fouladi Fard, Paola M Friedrich, Takeshi Fukumoto, Getnet Azeze Gedefaw, Ahmad Ghashghaee, Asadollah Gholamian, Arvin Haj-Mirzaian, Arya Haj-Mirzaian, Samer Hamidi, James D. Harvey, Hamid Yimam Hassen, Simon I. Hay, Chi Linh Hoang, Michael K. Hole, Nobuyuki Horita, Seyyed Nasrollah Hosseini, Mehdi Hosseinzadeh, Mohamed Hsairi, Melissa Maria Hudson, Kaire Innos, Farzad Jalilian, Spencer L. James, Amir Kasaeian, Tesfaye Dessale Kassa, Nicholas J Kassebaum, Peter Njenga Keiyoro, Yousef Saleh Khader, Jagdish Khubchandani, Neda Kianipour, Jeannette Kirby, Adnan Kisa, Sezer Kisa, Jonathan M Kocarnik, Paolo Lauriola, Alan D Lopez, Margit Mägi, Manzoor Ahmad Malik, Ali Manafi, Navid Manafi, Mohammad Ali Mansournia, Benjamin Ballard Massenburg, Varshil Mehta, Hagazi Gebre Meles, Tuomo J Meretoja, Tomislav Mestrovic, Seyed Mostafa Mir, Mehdi Mirzaei-Alavijeh, Dara K. Mohammad, Aso Mohammad Darwesh, Naser Mohammad Gholi Mezerji, Roghayeh Mohammadibakhsh, Milad Mohammadoo-Khorasani, Ali H Mokdad, Yoshan Moodley, Mahmood Moosazadeh, Maryam Moossavi, Farhad Moradpour, Shane Douglas Morrison, Kindie Fentahun Muchie, Mohsen Naghavi, Javad Nazari, Josephine W. Ngunjiri, Cuong Tat Nguyen, Long Hoang Nguyen, Son Hoang Nguyen, Trang Huyen Nguyen, Molly R Nixon, Andrew T Olagunju, Tinuke O Olagunju, Sok King Ong, Keiu Paapsi, Alyssa Pennini, David M. Pereira, Julian David Pillay, Mostafa Qorbani, Mohammad Rabiee, Navid Rabiee, Samira Raoofi, David Laith Rawaf, Salman Rawaf, Robert C Reiner, Nima Rezaei, Aziz Rezapour, Kedir Teji Roba, Les L. Robison, Carlos Rodriguez-Galindo, Gholamreza Roshandel, Saeid Safiri, Mohamadreza Salahshoor, Saleh Salehi Zahabi, Abdallah M. Samy, Milena M Santric Milicevic, Maheswar Satpathy, Susan M Sawyer, Seyedmojtaba Seyedmousavi, Hosein Shabaninejad, Masood Ali Shaikh, Amir Shamshirian, Morteza Shamsizadeh, Reza Shirkoohi, Soraya Siabani, Jasvinder A. Singh, Khairil SiRamlee, Rafael Tabarés-Seisdedos, Mohamad-Hani Temsah, Bach Xuan Tran, Irfan Ullah, Amir Vahedian-Azimi, Stein Emil Vollset, Theo Vos, Yasir Waheed, Girmay Teklay Weldesamuel, Hailemariam Mekonnen Workie, Rixing Xu, Mehdi Yaseri, Naohiro Yonemoto, Chuanhua Yu, Vesna Zadnik, Telma Zahirian Moghadam, Zoubida Zaidi, Alireza Zangeneh, Taye Abuhay Zewale, Arash Ziapour, Sanjay Zodpey, Christopher J L Murray, Christina Fitzmaurice, Nickhill Bhakta
Journal: The Lancet Oncology (2019)

<h2>Summary</h2><h3>Background</h3> Accurate childhood cancer burden data are crucial for resource planning and health policy prioritisation. Model-based estimates are necessary because cancer surveillance data are scarce or non-existent in many countries. Although global incidence and mortality estimates are available, there are no previous analyses of the global burden of childhood cancer represented in disability-adjusted life-years (DALYs). <h3>Methods</h3> Using the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 methodology, childhood (ages 0–19 years) cancer mortality was estimated by use of vital registration system data, verbal autopsy data, and population-based cancer registry incidence data, which were transformed to mortality estimates through modelled mortality-to-incidence ratios (MIRs). Childhood cancer incidence was estimated using the mortality estimates and corresponding MIRs. Prevalence estimates were calculated by using MIR to model survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated by multiplying age-specific cancer deaths by the difference between the age of death and a reference life expectancy. DALYs were calculated as the sum of YLLs and YLDs. Final point estimates are reported with 95% uncertainty intervals. <h3>Findings</h3> Globally, in 2017, there were 11·5 million (95% uncertainty interval 10·6–12·3) DALYs due to childhood cancer, 97·3% (97·3–97·3) of which were attributable to YLLs and 2·7% (2·7–2·7) of which were attributable to YLDs. Childhood cancer was the sixth leading cause of total cancer burden globally and the ninth leading cause of childhood disease burden globally. 82·2% (82·1–82·2) of global childhood cancer DALYs occurred in low, low-middle, or middle Socio-demographic Index locations, whereas 50·3% (50·3–50·3) of adult cancer DALYs occurred in these same locations. Cancers that are uncategorised in the current GBD framework comprised 26·5% (26·5–26·5) of global childhood cancer DALYs. <h3>Interpretation</h3> The GBD 2017 results call attention to the substantial burden of childhood cancer globally, which disproportionately affects populations in resource-limited settings. The use of DALY-based estimates is crucial in demonstrating that childhood cancer burden represents an important global cancer and child health concern. <h3>Funding</h3> Bill & Melinda Gates Foundation, American Lebanese Syrian Associated Charities (ALSAC), and St. Baldrick's Foundation.