The global burden of childhood and adolescent cancer in 2017: an analysis of the Global Burden of Disease Study 2017
File(s)
Published version
Author(s)
GBD 2017 Childhood Cancer Collaborators
Type
Journal Article
Abstract
BACKGROUND: 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). METHODS: 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. FINDINGS: 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. INTERPRETATION: 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. FUNDING: Bill & Melinda Gates Foundation, American Lebanese Syrian Associated Charities (ALSAC), and St. Baldrick's Foundation.
Date Issued
2019-09-01
Date Acceptance
2019-05-07
Citation
Lancet Oncology, 2019, 20 (9), pp.1211-1225
ISSN
1470-2045
Publisher
Elsevier
Start Page
1211
End Page
1225
Journal / Book Title
Lancet Oncology
Volume
20
Issue
9
Copyright Statement
© 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/)
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/31371206
PII: S1470-2045(19)30339-0
Subjects
Science & Technology
Life Sciences & Biomedicine
Oncology
SEX-SPECIFIC MORTALITY
SYSTEMATIC ANALYSIS
195 COUNTRIES
LIFE EXPECTANCY
TERRITORIES
DISABILITY
REGISTRIES
SURVIVAL
INJURIES
GBD 2017 Childhood Cancer Collaborators
1112 Oncology and Carcinogenesis
Oncology & Carcinogenesis
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2019-07-29