Prevalence and Pattern of Paediatric Malignancy at Bugando Medical Centre in Mwanza Region, Tanzania. - Mwanza, Tanzania | Catholic University of Health and Allied Sciences [CUHAS-Bugando] | 2024 - 31 Pages Includes References

Background Information:

The term "malignancy" refers to the presence of cancerous cells that have the ability to spread to other sites in the body (metastasize) or to invade nearby (locally) and destroy tissues. Malignant cells tend to have fast, uncontrolled growth and do not die normally due to changes in their genetic makeup. Malignant cells that are resistant to treatment may return after all detectable traces of them have been removed or destroyed (1). Cancers form one of the major causes of death in children aged 15years or less. They differ markedly from adult cancers in their nature, distribution and prognosis. Worldwide, childhood cancer burden is increasing and over 80% of children who develop cancers each year live in low and middle income countries. Whiles the outcome for cancers in the developed countries are good, the opposite is the case for patients in low and middle income countries. Early diagnosis of cancer is a fundamental goal because it allows an opportunity for timely treatment while disease burden is in its earliest stages. Consequently, prognosis may improve and a cure can be attained with minimal side or late effects. Geographic differences in childhood cancer incidence rates suggest a genetic and environmental influence on disease susceptibility. Socioeconomic status, malnutrition, exposure to viral infections and malaria are thought to play important roles in cancer pathology and clinical characteristics (2).

Estimated over 400000 children diagnosed with cancer each year, most live in low and middle income countries, for them treatment is often unavailable only about 20- 30% of those children survive compared to more than 80% in high income countries (3). Incidence and mortality rates of childhood cancers vary worldwide. Some of this variation may be attributable to differences in reporting. In children aged 0-14 years’ incidence rates range from less than 100 per million in areas of sub-Saharan Africa and India to more than 150 per million in some populations of North America and Europe.

In the United States, the estimated incidence of pediatric cancers is 178.3 per million children aged birth to 19 years. In the birth to 14-year-old age range leukemia account for approximately 30% of all childhood cancers, followed by tumors of the central nervous system (CNS) (26%), lymphomas (11%), soft tissue sarcoma (6%), neuroblastoma (6%), Wilms tumor (5%), and Hodgkin lymphoma (5%). Numerous rare tumor types account for the remainder. In the 15- to 19-year-old age range, lymphoma is the most common malignancy and accounts for 21% of cancers in this age group, followed by CNS tumors (17%), leukemia (14%), germ cell tumors (12%), thyroid tumors (11%), and melanoma (5%).

The decreased mortality rate of pediatric cancers has been one of the major success stories of medicine in the 20th century, and mortality has continued to improve in the early 21st century. Overall mortality has decreased by more than 50% between 1975 and 2010, and overall survival rates of childhood cancers are now approximately 80%. Improvements in the survival rates of leukemia, Hodgkin lymphoma, gonadal, and renal tumors have been notable successes (4).

These improvements have led to the new challenge of caring for a growing number of cancer survivors. The risk of a second cancer appearing within 20 years after an initial diagnosis of acute lymphoblastic leukemia (ALL) is approximately 10%. The existence of this group also suggests that risk factors (eg, treatment, heredity, and other environmental factors) might be identifiable. For instance, the risk of acute myelogenous leukemia (AML) with the 9:11 translocation is approximately 3-6% within 5 years of therapy that includes high-dose topside or alkylating agent therapy, depending on dosage and tumor type. Additionally, in utero exposure to diagnostic radiation has been associated with an increased risk of childhood cancer(5).


Publisher. No.: Wurzburg Road 35, Premises, Post Code: 33102 | P. O. Box 1464 Mwanza, Tanzania | Phone: (255) 28-298-3384 | Fax: (255) 28-298-3386 | Email: vc@bugando.ac.tz | Website: www.bugando.ac.tz.

Subjects--Personal Names: --Paediatrics and Child Health--Parasitology and Entomology