Title: Childhood Cancer and Treatment Disparities
Author:
Section/SPIG: Maternal and Child Health
Issue Date:
Two new publications have appeared that address critical policy issues concerning childhood cancer and treatment disparities in the United States and internationally.
The Institute of Medicine recently issued its report Making Better Drugs for Children with Cancer. It is available to read and purchase at <http://www.nap.edu/catalog/11259.html>. The report shows that market forces by themselves are not sufficient to ensure the research needed to produce new drugs for children with cancer. The report recommends forming new public/private partnerships to bring government, industry, researchers, and advocacy groups together to support research and development in this critical field.
The report analyzes childhood cancer treatment in the light of historic advances. "Over the past 40 years, researchers and clinicians have achieved long-term survival for most children and adolescents with cancer," said pediatric oncologist Peter C. Adamson, MD, chief of the Division of Clinical Pharmacology and Therapeutics at The Children's Hospital of Philadelphia, and an editor of the report. "However, our therapies are not curative for 30 percent of children, and for children who are cured, the short-term and long-term side effects of current treatments are often too high."
More than 250,000 children are diagnosed with cancer each year, worldwide. According the Children's Cancer Trust in the United Kingdom, the actual number of cases is unknown and thought to be significantly higher as few children in developing countries receive treatment and many die undiagnosed. Even with the present limitations of cancer treatments for children in the United States, the now-80 percent survival rate here is mirrored by a mortality rate in low- and medium-income countries of almost equal size, i.e. in those countries, only some 10-20 percent get treated and survive. The majority often also die in extreme anguish, with no access to pain relief either.
As infectious disease mortality decreases, childhood cancer has become a leading cause of death in many countries. For example, in Mexico, cancer is now the 2nd cause of death in children age 5-14, just as in the United States. In the United States, cancer is the single most fatal childhood disease. It is also not completely accurate to classify cancer as a noncommunicable disease, as there are known viral and infectious causes for some types such as Burkitt's lymphoma, common among children in Africa. And new research has identified viral causes of some leukemias and lymphomas. Access to affordable and appropriate medicines, of course, is an essential part of the strategy.
Also of note is an article recently publushed in the New England Journal of Medicine (NEJM)(352 (21) : 2158-2160 May 26, 2005), entitled Saving the Children: Improving Childhood (Cancer Treatment in Developing Countries, <http://content.nejm.org/cgi/content/full/352/21/2158>.
The authors, Raul C. Ribeiro, MD, and Ching-Hon Pui, MD, close with this message: "It has been said that if we are to preserve civilization, we must make certain its benefits are available to the many, not reserved for the few. The development of curative treatment for children with cancer is a benchmark for medical progress, and such treatment must not be sequestered within the borders of a few countries. The strategy we describe is only a start, but it could ignite a spirit of achievement that may ultimately reach even the least privileged nations."
The authors are also members of the International Society of Pediatric Oncology ( SIOP), which last year requested that the WHO put cancer treatment drugs in the priority group of the Essential Medicines List. To date, SIOP has had no response.
For more information, contact:
Joana Ramos, MSW
Cancer Resources & Advocacy
7303 23rd Ave. NE
Seattle, WA 98115
206) 229-2420
<http://ramoslink.info/>