Recently, the first study on the current situation of cancer incidence and accessibility of health services in children and adolescents in my country was published in the Lancet. The study was completed by the team of Ni Xin, a professor at the Beijing Children's Hospital affiliated to the Capital Medical University of the National Children's Medical Center under the guidance and support of National Health Commission.
This study reports for the first time a comprehensive data on the latest incidence of cancer in children and adolescents in my country. The results show that from 2018 to 2020, a total of 121,145 children and adolescents were diagnosed with cancer in my country. The study also found that accessibility of health services, as one of the determinants of a healthy society, has an important impact on the incidence of cancer in children and adolescents in my country. The study further pointed out intervention measures to improve the current cancer status of children and adolescents in my country.
new cancers in children and adolescents in 5 years have more than 40,000 cancers in children and adolescents around the world. High-income countries report higher rates of cancer in children and adolescents than in low- and middle-income countries. However, more than 80% of childhood cancer cases occur in low- and middle-income countries.
Due to the lack of high-quality childhood cancer registration data and the existence of more than 16% of the migrant population, the data has been missing. The incidence of cancer in children and adolescents previously reported in my country is underestimated. In China, the incidence of cancer in children and adolescents based on the perspective of economic development level has never been reported.
In June 2019, the National Health Commission approved the establishment of the National Children's Oncology Monitoring Center for the Beijing Children's Hospital Affiliated to Capital Medical University of the National Children's Medical Center. As of September 2022, the pediatric tumor monitoring network has covered 587 pediatric tumor monitoring sites across the country, and 1.86 million pediatric cancer case information has been registered.
Ni Xin's team deeply analyzed the monitoring data of the National Children's Tumor Surveillance Network and the national related database information, and estimated the cancer incidence rates of Chinese children (0 to 14 years old) and adolescents (15 to 19 years old) from January 1, 2018 to December 31, 2020. Based on the international classification criteria for children’s tumors, the latest incidence rates of 12 major diagnostic groups, 47 subgroups and 81 cancer subtypes were reported.
study results show that from 2018 to 2020, there were 40,380 new children and adolescent cancer patients each year; the average total incidence rate in the three-year period was 126.48/million; the incidence rate of cancer in children aged 0 to 14 was 122.86/million, and the incidence rate of cancer in adolescents aged 15 to 19 was 137.64/million. Among children, the top three cancers are leukemia (42.33/million), central nervous system tumor (19.59/million), and lymphoma (11.54/million); among adolescents, malignant epithelial cancer and melanoma rank first (30.39/million), followed by leukemia (30.08/million) and central nervous system tumor (16.75/million).
It is worth noting that this study found that leukemia accounts for about 32%, lymphoma accounts for about 9.7%, and nearly 60% of the patients are solid tumor patients, indicating that the epidemiology burden of solid tumors in children is underestimated.
provides data support for optimizing the configuration of children's cancer health resources Countries attach great importance to the prevention and control of major children's diseases in my country, among which diseases represented by childhood cancer have received special attention. The National Health Commission is the first in the country to carry out disease treatment and full-process management of childhood cancer, and has included 220,000 childhood cancer patients in the full-process management. The biggest innovation of this study is to study four health service indicators related to the diagnosis of children's tumors in the country and different human development index regions based on the Human Development Index. It was found that the incidence of children's tumors showed a significant positive correlation trend with the Human Development Index, and the population and geographical density of pediatric oncologists, pathologists/technicians, children's tumor diagnosis and treatment institutions, and pediatric beds were also positively correlated with the level of the Human Development Index. This research result not only provides quantifiable data evidence for the precise optimization of the allocation of childhood cancer resources in health administrative department and the formulation of childhood cancer prevention and control measures and policies in my country, but also provides objective evidence for the necessity and importance of promoting the construction of national medical centers and regional medical centers in recent years. Ni Xin's team suggested that in the process of promoting graded diagnosis and treatment of , we should fully consider the construction of children's cancer health service capacity as one of the standards for establishing and evaluating regional children's medical centers and regional cancer centers. The system requires all regions to equip high-quality childhood cancer health service resources to ensure that cancer children enjoy convenient medical services in the region and even in the province, and reduce the non-medical expenses caused by visiting clinics in other places. At the same time, strengthen the linkage between primary medical and health institutions/maternal and child health hospitals, national medical centers and regional medical centers, and improve the early identification and early diagnosis of childhood cancer in various places. contributes to global childhood cancer control The research report published this time pointed out that with the popularization of medical insurance in my country (96.3%) and the implementation of the cross-provincial medical insurance payment and settlement system, children and adolescent cancer patients can choose hospitals or cross-provincial medical services, and are not restricted by the referral model, which greatly alleviates the dilemma of cancer children in areas with limited childhood cancer diagnosis and treatment resources to enjoy high-quality health services. This study provides valuable scientific evidence and practical experience for low- and middle-income countries to improve service accessibility, promote convenient medical services for children with cancer, and reduce the burden of disease. Sumit Gupta of the Hospital for Sick Children in Toronto, Canada evaluated this study represents a very successful childhood cancer program in low- and middle-income countries, responding to the World Health Organization's global childhood cancer initiative, contributing to significant progress in global childhood cancer control. Ni Xin, director of the National Children's Tumor Monitoring Center, said that the monitoring center will further evaluate the disease burden of children's tumors in my country, including childhood tumor survival and mortality; develop a specialized childhood tumor disease database based on the national children's tumor monitoring platform, establish standardized diagnosis and treatment guidelines for different diseases; evaluate the effectiveness of childhood tumor prevention and control measures; carry out research on children's tumor survivors and related research on children's tumor medication to promote drug research and development and results transformation; promote the formulation and effectiveness evaluation of children's tumor policies. Original text was published in Journal of Medical Sciences (2022-09-30 Edition 6 Focus)
