Armed Conflict's Growing Impact on Child Cancer Patients
Armed Conflict's Growing Impact on Child Cancer Patients
A new interdisciplinary study reveals regions experiencing armed conflict account for an increasing proportion of all global cancer cases and deaths among children.
More than half of all child cancer deaths worldwide now take place in regions wracked by armed conflict—due to wide disparities in diagnoses and treatment.
Child cancer experts estimate that more than 11 million children will die from cancer by 2050, particularly in these battleground countries where children’s health is already compromised.
A new study published in The Lancet Oncology by SHP’s Paul Wise, MD, MPH, a pediatrician and an expert on children living in conflict and colleagues, now provides three decades of data to help policymakers and child cancer advocates build a sustained commitment to strategic collaborations and technical innovations to ensure child cancer patients have better chances of survival in some of the most violent locations on earth.
“The vast majority of childhood cancers are curable,” said Wise. “Not providing access to care wherever the children live is not only tragic—it is unjust.”
Wise—who has traveled the world as a child health researcher and advocate for the United Nations and the U.S. Federal Court on our southern border with Mexico—worked with colleagues at St. Jude Children’s Research Hospital, Duke University, the University of Washington and the University Medical Center Freiburg in Germany.
They used data from the Global Burden of Disease (GBD) and the Uppsala Conflict Data Program (UCDP) from 1990 to 2019, to give a comprehensive overview of the impact of armed conflict and cancer outcomes in children aged 0 to 19 years. The researchers compared cancer mortality rates between countries in conflict and those that are in relative peace.
“To improve global childhood cancer care, understanding the relationship between armed conflict, measured by battle-related deaths, and childhood cancer, is essential,” they wrote. “Comprehensive global databases … allow a high-level understanding of the impact of armed conflict on childhood cancer and how these patterns have changed during the past three decades.”
Paul Wise (top left) helping evacuate child cancer patients from Ukraine. Photo: Paul Wise
Armed Conflict Exacerbates Child Cancer Risk
The researchers found that children living in countries with armed conflict accounted for an increasing proportion of global child cancer deaths over the last 30 years. They found half of the children around the world lived in countries experiencing armed conflict—and that these areas accounted for nearly 60% of all childhood cancer deaths.
They determined that the child cancer burden is disproportionately concentrated in low- to middle-income countries, where more than 90% of all children at risk of developing cancer live.
“Many countries have successfully reduced (child cancer) mortality rates over recent decades, leading to aspirational projections of a great convergence in mortality rates for children,” the authors write. “However, we found that for children with cancer in conflict settings, there is a great divergence, with higher cancer mortality rates and an increasing proportion of global cancer deaths for children in countries with armed conflict compared with countries without conflict.”
The WHO’s Global Initiative for Childhood Cancer in 2018 brought together stakeholders from around the world with the goal of increasing survival for children with cancer to at least 60% by 2030. But armed conflicts are upending that goal due to destroyed hospitals, displaced health-care workers and lack of essential medical services.
“To meet this challenge, new multidisciplinary collaborations will be required, including those that bridge humanitarian strategies, security studies, and clinical expertise to care for children with serious, chronic illnesses,” writes Wise and his colleagues. “This work, in turn, will require innovation in both pragmatic systems, which ensure security and access to effective cancer treatments, and in advanced care systems, which can enhance service quality and coordination in even the most dynamic conflict settings.”
