Panorama of Pediatric Oncology Focused on the State of Rio De Janeiro, Brazil, 2017

Abstract

Background and context: Childhood cancer has low incidence, but it's 1st cause of death by disease from 1-19 years in Brazil. Given the lack of preventive measures, access to early diagnosis and treatment are important control actions. Aim: Elaboration of an advocacy tool based on consolidated data of incidence, mortality and morbidity of childhood cancer in Brazil. Strategy/Tactics: Collaborative work process with specialists: 1) evaluation of previous material, databases, available publications and the public ordinances and norms; 2) extraction and analysis of information, providing contextualized and commented content; 3) disclosure: it's launched annually to celebrate National Childhood Cancer Day, in social networks, media, and also presented at meetings, lectures and congresses for key stakeholders (print and electronic format). Program/Policy process: Consulted sources in 2017 were: national census, national registry of health facilities, mortality information system, cancer mortality atlas, hospital-based cancer registry (HBCR) system, and materials from national institute of cancer and IARC. It's estimated 630 new cases/year for the state of Rio de Janeiro (SRJ), 390 in the metropolitan region and 250 in the capital. Incidence rates in the world, Brazil and SRJ per million were: 140.6; 126.5 and 132 within ages from 0-14 and 185.3; 157.2 and 166 for ages 15-19. The classification of tumor types in Brazil, SRJ and capital were, respectively: 40%, 41% and 39% of nonsolid tumors; 43%, 59% and 61% of solid tumors (from which 28%, 24% and 29% are solid tumors of central nervous system). Total deaths per childhood cancer/week is 1540 in the world, 55 in Brazil and 4 in SRJ, being 2nd cause of death (behind external causes) and 1st cause of death due to illness (7.6%) within ages of 1-19 in Brazil. Authorized hospitals for childhood cancer treatment: 77 units in Brazil and 7 in SRJ, of which 70 and 6 have HBCR, respectively. Only 14 Brazilian units and 1 in ERJ treat a median of > 100 new cases/year. In SRJ, 75% of diagnosed cases started treatment within 15 days, and 15% of adolescents are treated with adults. What was learned: It's needed more involvement of pediatric oncologists and managers in analyzing information and its use in decision making, since many don't use existing databases routinely. Another challenge is to return information to those who register it, and thus help in understanding the working process to qualify and value it through appropriate strategies. Collective construction of consolidated information is an important advocacy tool for health practitioners, managers and even general public: it facilitates understanding the pediatric oncology scenario and exposes opportunities for improvement to deal with incomplete or low-skilled information. Ultimately, it allows and stimulates social control of the entire society, and can be used as support for the planning and alignment of public policies to local problems.[Figure: see text][Figure: see text][Figure: see text]