The International Agency for Research on Cancer (IARC, for its acronym in English), an agency dependent on the World Health Organization (WHO), has focused on the marked inequalities between regions of the planet in the diagnosis and treatment of childhood cancer, a disease that in 2024 affected more than 275,000 minors and young people up to 19 years old.
Coinciding with Childhood Cancer Awareness Month, the IARC has emphasized that the actual figures of new cases could be "much higher" than the latest estimates from GLOBOCAN. This possible underreporting is attributed to the difficulties in detecting the disease and to the shortcomings in access to healthcare, diagnostic tests, and cancer registries in numerous countries.
The agency has pointed out that recent studies conducted by its teams and collaborators show that inequalities in childhood cancer go far beyond the mere quantification of the burden of the pathology. Thus, it has warned that Africa, Asia, South America, and the Caribbean account for nearly 94 percent of childhood cancer deaths, and that minors in these areas have almost double the risk of dying from this cause compared to those in Europe and North America, despite the fact that higher incidence rates are recorded in these latter regions.
In light of this scenario, the IARC has highlighted the projects it is promoting to reduce these gaps. Among them, the initiative "Childhood Cancer: Epidemiology, Research, and Omics" (CICERO) stands out, which has begun fieldwork in Kenya, Malawi, and Tanzania in order to analyze in detail the delays in diagnosis, access to oncology services, adherence to treatments, and clinical outcomes.
The agency has also reminded that tumors affecting children and adolescents differ greatly from the predominant cancers in the adult population and that the causes of the disease in the pediatric age are much less clear, complicating the development of effective preventive strategies.
In this area, the research is aimed at deepening the role of genetic susceptibility and environmental exposures before birth and during the early years of life. The project "Susceptibility, Environmental Exposures and Onset of Disease in Acute Myeloid Leukemia" (SEED-AML), which IARC will coordinate along with international partners, aims to unravel these early events and advance in prevention.
Impact of environmental exposures
The Epi-BEAM project also focuses on clarifying how environmental exposures can influence the onset of childhood cancer. In particular, it investigates whether early exposure to mycotoxins, contaminants present in some foods, can interact with Epstein-Barr virus infection and cause epigenetic changes that increase the likelihood of developing Burkitt lymphoma, one of the most common pediatric tumors in certain areas of sub-Saharan Africa.
Also aimed at studying environmental factors, the project "ELI-ALL" (Towards the Elimination of Acute Lymphoblastic Leukemia in Children) has recently obtained funding to analyze how air pollution, perfluoroalkyl and polyfluoroalkyl substances (PFAS), and pesticides contribute to the formation of pre-leukemic clones and the subsequent onset of ALL.
IARC has also launched a new subsite within the Global Cancer Observatory, called SURVCAN, which facilitates the visualization of childhood cancer survival data from high-quality population registries from Africa, Asia, Latin America, and the Caribbean.
The efforts of the agency's scientific teams to strengthen the global response to childhood cancer, which also include initiatives such as the standardization and improvement of registration systems, aim for all children, regardless of their place of residence, to have greater chances of overcoming the disease. WHO maintains the goal of achieving a global survival rate of at least 60 percent by 2030.