Introduction
Survival from childhood cancers has improved tremendously over the last
five decades [1]. Indeed, about 80% of childhood cancers can be
successfully treated in high-income settings with good access to modern
treatments and supportive care. Unfortunately, about 90% of children at
risk of childhood cancer each year reside in developing countries, with
limited availability and accessibility to technical platforms for early
diagnosis and management of childhood cancers [2–5]. Since children
depend on their parents or carers, their symptoms might be overlooked,
leading to delayed diagnosis, misdiagnosis and late treatment
initiation, eventually leading to poor patient outcomes [6]. In
addition, children are often neglected in cancer control programs,
partly because of a paucity of data on childhood cancer risk and
survival [7].
In 2019, pediatric cancers represented the sixth leading cause of the
global burden of cancers and the ninth leading cause of global childhood
disease burden [1]. Despite representing only 1% of global cancer
cases diagnosed yearly, childhood cancers are associated with
disproportionately high disability-adjusted life-years (DALYs) because
children have a longer life expectancy. For instance, over 80% of the
11.5 million DALYs attributed to childhood cancers in 2019 occurred in
LMICs [1].
In Cameroon, childhood cancers account for 1 to 2% of all cancers, and
malignant hemopathies like acute lymphoid leukemia (ALL) and acute
myeloid leukemia (AML) represent about 50% of childhood cancer cases.
Although 90% of these cancers are curable, over 80% of patients seek
care at an advanced stage of the disease, leading to high mortality
rates of up to 40% [8]. For example, data from the Yaoundé
population-based cancer registry estimates an incidence of childhood
cancers of 125/1,000,000 children, with approximately 1552 incident
cases of childhood cancers expected to occur annually [9]. Despite
this incidence level, in 2018, the pediatric oncology unit of the Mother
and Child Centre of the Chantal Biya Foundation [MCC/CBF] (The
Reference Pediatric Hospital located in Yaoundé, Cameroon) recorded only
150 new cases of childhood cancer11Pediatric Oncology Unit
Service Register, Mother and Child Center/Chantal Biya Foundation,
representing below 10% of the expected number, which is likely an
underestimation of the true value.
Data on the management of childhood cancers in Cameroon are warranted
for policy implementation and prioritization of expenditures. Therefore,
this study sought to investigate the key obstacles to optimal pediatric
cancer care in the two functional oncology services in Cameroon.
Specifically, we aimed to describe pediatric cancer service
availability, human resource capacity involved in pediatric cancer care,
treatment completion, patient education and disclosure as well as data
management system for pediatric cancers.