Abstract 26: Correlation of Childhood Cancer Mortality Trends and CureAll Metrics for 134 LMICs

Abstract

Abstract Purpose: Disparities in cancer outcomes still remain in low-and-middle income countries (LMICs), where less than 30% of children living with cancer survive. In this context, the Global Initiative for Childhood Cancer has set the goal of achieving at least 60% survival for all countries by 2030. The aim of this study was to describe trends in childhood mortality rates for LMICs over time and evaluate their association with the health system metrics related to the WHO CureAll framework. Methods: In this ecological study, childhood cancer was defined as all-cancers for the age group of 0-14 years old. Data were collected from public data sources including the Global Burden of Disease, WHO cancer profiles and World Bank. Descriptive analyses were performed to investigate mortality rate patterns over time (1990-2019). Exposure variables including density of hospital beds, density of CT scanners, density of MRI scanners, density of density of external beam radiotherapy, out-of-pocket expenditure, and universal health coverage index were evaluated against percent change of mortality of cancer rates (1990-2019). Smooth regression lines were used to visualize inflections points within income level groups. Results: A total of 134 LMICs were included in this study. Overall, low-income countries had the major decrease in childhood mortality rates from 1900 to 2019. The top three countries with the highest decrease in rates were Malawi, Ethiopia, and Zambia deaths (-22.6 to -9.1/100,000 population). The top three countries with the highest increase in rates were Botswana, Burkina Faso, and Dominica (+1.2 to +1.8 deaths/100,000 population). The factors associated the most with changes in the childhood cancer mortality rates over time were improvements in infrastructure, such as increasing hospital beds and the availability of cancer treatments, increasing universal coverage, and decreasing out-of-pocket expenditures for healthcare costs. Conclusion: An improved understanding of cancer mortality trends and their relation with health system variables in LMICs is important to monitor and evaluate progress in survival rates for children living with cancer in these countries. This study intends to provide insights on the use of health system metrics related to the WHO CureAll framework as priority interventions for childhood cancer in LMICs. Citation Format: Hannah Rice, Emily Smith, Cesia Cotache-Condor, Esther Majaliwa, Pamela Espinoza, Madeline Metcalf, Henry Rice. Correlation of Childhood Cancer Mortality Trends and CureAll Metrics for 134 LMICs [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 26.