Childhood and Adolescent Cancer Emerges as a Pressing Public Health Concern
It is estimated that cancer in children and adolescents accounts for up to 3% of all malignant tumors, being one of the main causes of death among these individuals. A study carried out by the Faculty of Public Health (FSP) at USP on the epidemiology of cancer in this age group, in the city of São Paulo, between 1997 and 2016, points out that, despite the belief that the majority of children do not develop serious illnesses, the issue presents itself as a public health problem.
Beatriz Bertuzzo Möller, master’s student at FSP and author of the study, explains that, with the reduction in mortality from communicable diseases, cancer has become one of the main causes of death in children aged 0 to 14 and adolescents aged 15 to 19.
Public health
The development of cancer in this age group presents itself as an important problem for the national public health system, as it indicates a direct impact on the provision of the service — through changes in the provision of assistance, the need for continuous monitoring of the disease and the implications significant impacts on quality of life.
One of the most important points for therapeutic success in children and adolescents is early diagnosis. Thus, it is possible to observe that, even today, progress in available treatments is not uniform for the entire population, and it is possible to observe, in many cases, that the level of economic development is directly associated with access to health services. “Although cancer is considered a rare disease in this age group, around 430 thousand new cases are expected in the world and 8 thousand cases in Brazil in 2023 alone”, points out the researcher.
Methods
To carry out the research, Beatriz explains that data on new cases — which occurred between 1997 and 2016 — was obtained from the São Paulo Population-Based Cancer Registry Database, which is located in the Department of Epidemiology at FSP. Information on deaths, which occurred between 1997 and 2021, was obtained through the Mortality Information System of the Ministry of Health on the DataSUS website.
The researcher comments, therefore, that during most of the period it was possible to observe a drop in incidence and mortality rates. The drop in the second rate was already expected by most researchers, however, it is important to assess that the drop in incidence may be associated with the lack of diagnosis. Beatriz explains that this happens because cancer symptoms at this age can be associated with the occurrence of other diseases, which ends up making diagnosis difficult.
To improve this scenario, the training of professionals working in the area is necessary. Currently, cancer in children and adolescents is divided into 12 main groups, with emphasis on leukemia, lymphomas and tumors that affect the Central Nervous System. These types are also the most common in other countries and regions, and it is possible to note that this is not an exclusively national pattern.
Finally, the research concluded that the incidence rate in Brazil, in the period between 1997 and 2016, was 195 per million — a value considered high when compared to other countries in Latin America, but which is similar to European cases. The mortality rate in 1997 and 2021 was 47.9 per million, a value that is considered high when compared to countries in Europe and North America, but which is similar to data from Asia and Africa.