Concerned experts are urging faster action to help reduce childhood cancer rates and boost survival, while calling for investment in registries as well as vital infrastructure.
Annually, more than 200 000 children under 15 are diagnosed with cancer worldwide, and nearly 75 000 die from the disease. Most deaths occur in Africa, Asia and Latin America, even though childhood cancer is more common in Europe and North America. In high-income countries, more than 80% of children survive, while the global average is just 37%.
Why is the gap so large?
An international study using data from the International Agency for Research on Cancer (IARC), analysed data from nearly 17 000 children in 23 countries across Africa, Asia and Latin America, and the results show striking differences: in Puerto Rico, almost 80% of children with central nervous system tumours survive three years after diagnosis, compared with only 32% in Algeria.
For leukaemia, the disparity is even greater – from 30% in Kenya to 90% in Puerto Rico.
Survival is closely linked to a country’s level of development. These variations largely reflect differences in healthcare systems and can be attributed to late diagnosis, limited treatment options, suboptimal quality of care, or treatment abandonment.
In addition, many countries lack reliable cancer registries, making it difficult to determine the true scale of the problem.
“The stark differences in survival – from more than 80% in high-income countries to less than 40% in some low- and middle-income countries – underscore the urgent need to act,” said Dagrun Slettebø Daltveit, first-author of the study, from the University of Bergen in Norway.
Better monitoring is needed
“The WHO has set a goal to increase global survival to at least 60% by 2030,” said Dr Isabelle Soerjomataram, deputy head of the cancer surveillance branch at IARC, “and to achieve this, countries must invest in population-based cancer registries to measure disease burden and track progress in childhood cancer control.”
The study provides essential benchmarks for monitoring improvements and demonstrates that many more lives can be saved through early diagnosis and effective treatment.
“Our findings support the WHO goal of achieving at least 60% survival for children with cancer by 2030, but to reach this target, investment in cancer registries and health infrastructure is critical,” added Daltveit.
The research is part of the Cancer Survival in Countries in Transition (SURVCAN-3) project, initiated by the International Agency for Research on Cancer (IARC) in collaboration with the IARC Global Initiative on Cancer Registry Development (GICR).
Study details
Childhood cancer survival in Africa, Asia, Latin America and the Caribbean, during 2008-2017 (SURVCAN-3): a population-based benchmarking study of 16 821 children
Dagrun Slettebø Daltveit, Eileen Morgan, Eva Steliarova-Foucher, et al.
Published in JNCI: Journal of the National Cancer Institute on 15 December 2025
Abstract
Background
Accurate information on childhood cancer survival is essential for improving health systems. Survival is believed to be low in low-resource countries, but population-based survival estimates are scant. We aim to provide reliable and comparable survival estimates in these settings.
Methods
We included 16 821 patients from 47 population-based cancer registries in 23 countries in Africa, Latin America and the Caribbean, and Asia. We used the Cancer Survival in Countries in Transition project data (children aged younger than 15 years, diagnosed 2008-2012, followed until 2014) and data from Rwanda (2013-2017, followed until 2022). We estimated 1-year, 3-year, and 5-year observed survival using the Kaplan–Meier method, by diagnostic group, country, region, Human Development Index, income, and sex.
Results
Survival was higher in registries included from the Caribbean (namely, Puerto Rico [United States], Martinique [France]) and Central America (Costa Rica), Asia, and the Middle East and North Africa compared with those included from South America and sub-Saharan Africa. Survival correlated with the Human Development Index. For leukaemia, 3-year survival varied from 30.4% (95% confidence interval [CI] = 12.4% to 50.6%) in Kenya to 89.5% (95% CI = 83.8% to 93.2%) in Puerto Rico; for central nervous system tumours from 32.0% (95% CI = 13.9% to 51.8%) in Algeria to 79.3% (95% CI = 69.1% to 86.5%) in Puerto Rico. The findings should be interpreted with care, as registry coverage varies and may not reflect national and regional survival.
Conclusion
The variability of the population-based survival estimates across predominantly low- and middle-income countries highlights gaps in cancer registration, access to care, and quality of care. This study provides benchmark data for the World Health Organisation Global Initiative for Childhood Cancer generated by population-based cancer registries, which should be supported in all countries.
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