Professor Gita Naidu, chair of the South African Children’s Cancer Study Group, Sandhya Singh director, non-communicable diseases,National Department of Health, and Hedley Lewis, CEO of the CHOC Childhood Cancer Foundation South Africa examine some of the issues why childhood cancer still occurs.
Many factors are responsible for delays in childhood cancer. These include the child’s age, family’s socioeconomic status, parental educational level, distance of residence from the hospital, cancer type, site, and stage.
Many children in low- and middle-income countries have poor access to hospitals, which in turn lack essential diagnostic tests, experience a shortage of nursing medical and surgical personnel, inadequate and erratic supply of basic pharmaceutical and chemotherapeutic agents, and an absence of radiotherapy, surgical and intensive care facilities.
These are but some of the factors which contribute to patients presenting with advanced disease and resultant poorer outcomes.
However, for a favourable outcome and improved overall survival, it is imperative that children are diagnosed early for effective treatment of early-stage disease.
As neonatal, infant and child health improves in South Africa, communicable diseases, such as respiratory and diarrhoeal diseases, HIV-AIDS, and tuberculosis, are better controlled.
By focusing on non-communicable diseases such as childhood cancer and identifying these diseases early, access to the correct diagnostics and therapeutics and the availability of supportive care to improve overall survival of our children with cancer is ensured.
The burden of the Covid-19 is further testing fragile African health care systems. Many caregivers are unemployed due to national lockdowns, there are inadequate transport systems, and caregivers are afraid to venture out of the safety of their homes. Sadly, this could mean even further delays in the diagnosis of childhood cancer.