Developing tools for healthcare professionals in LMICs to increase earlier diagnoses and cancer survival in children

  • C/Can marks International Childhood Cancer Day with launch of task force
  • Cancer is one of the leading causes of death among children and adolescents worldwide.
  • International group of experts drafts a how-to guide on childhood cancer.

To mark International Childhood Cancer Day, City Cancer Challenge (C/Can) is announcing the launch of a special task force focused on helping cities in low- and middle-income countries (LMICs) to make early diagnosis for childhood cancer. The task force’s first priority has been to produce the “C/Can Guide on How to Develop a Training Programme for the Management of Childhood Cancer at the Primary Healthcare Level”.

This guide has been constructed to help avoid missed diagnoses, reduce the time from suspicion to diagnosis, improve early referral, reduce treatment-related mortality and provide better supportive care to survivors in LMICs, as Dr Thet Ko Aung, C/Can’s Senior Manager of Technical Cooperation, explains:

“Cancer is one of the leading causes of death among children and adolescents worldwide: the WHO estimates that approximately 400,000 children around the world are diagnosed with cancer each year; around 80% of those children live in LMICs, where their chance of survival is unacceptably low.”

Since its inception, C/Can has been supporting the cities around the world where it works to improve equitable access to quality cancer care. Central to this has been a focus on helping local health services to improve their capacity to increase early diagnosis. But until now, C/Can has not focused specifically on childhood cancer.

When a city joins C/Can, it undertakes a City Engagement Process. A cornerstone of this is a needs assessment that garners in-depth information on the quality and capacity of cancer care services, covering core aspects like radiology and nuclear medicine, pathology and laboratory medicine, systemic treatment, radiotherapy, surgery and supportive and palliative care. As a result of this process, C/Can cities now have significant information about the needs and gaps related to childhood cancer.

C/Can puts the focus on early diagnosis of childhood cancer

During the needs assessment process conducted by C/Can’s first four cities of Cali, Asuncion, Kumasi and Yangon, all identified issues such as late-stage at presentations, delayed referrals and high mortality due to the side effects of cancer treatment, as the main barriers to providing equitable cancer care for children.

In response,  C/Can has set up a technical task force focused on childhood cancer made up of leading experts in the field from those cities. The task force is coordinated by Dr Oscar Ramírez, a leading specialist in Paediatric Haematology and Oncology in Cali, Colombia and who has been involved in the City Cancer Challenge (C/Can) initiative in Cali from the start,  both as a key member of the City Executive Committee (CEC), as well as Chair of the Technical Committee, leading the coordination and implementation of the projects prioritised by the CEC.

He will be joined on the task force by Aye Aye Khaing, Head of Department of Haemato-Oncology Unit, Yangon Children Hospital, Yangon, Myanmar; Angélica Samudio, Paediatric Haemato-Oncology Department, Hospital de Clinicas, University of Asuncion Asuncion; Vivian Paintsil, Senior Specialist Paediatrician, KATH, Kumasi; Lorna Renner, Head of the Paediatric Oncology Unit, Korle Bu Teaching Hospital, Accra; Jaques Van Heerden, Universitair Ziekenhuis Antwerpen, Division of Pediatric Oncology and Haematology, Belgium; Joyce Kambugu, Head of Paediatric Oncology at the Uganda Cancer Institute.

As Dr Ramirez explains, a major problem for LMICs is insufficient knowledge among health professionals that often prevents them from suspecting, referring and providing proper support to children with probable cancer: “When children with cancer are achieving cure, it is of the utmost importance that health providers learn about the impact of late effects of cancer treatment. For children in need of palliative care, adequate management of pain, proper nutrition and other issues ensuring access to these services in their home town should be part of their humanised treatment of cancer.”

To address this, the task force has envisioned and drafted “The C/Can Guide on How to Develop a Training Programme for the Management of Childhood Cancer at the Primary Healthcare Level”, a syllabus for a childhood cancer training programme that can be applied to different local contexts, whether in C/Can cities or others worldwide.

The main goal of the syllabus is to provide healthcare professionals with skills in childhood cancer clinical diagnosis, the management of treatment complications, supportive therapy and long-term follow-up of children undergoing different cancer treatment modalities.

The final draft version is now being subjected to a virtual consultation process with C/Can cities.

“The C/Can how-to guide on childhood cancers will enable cities to address the key gaps in diagnosis and provide access to quality cancer care in childhood cancers that will be the resource for developing training programmes to build up the capacity of primary health care professionals, concludes Jaques Van Heerden, Universitair Ziekenhuis Antwerpen, Division of Pediatric Oncology and Haematology.

C/Can has already produced other how-to guides, such as the resource-appropriate guidelines for cervical cancer and breast cancer management respectively; Guidelines for preparing a radiotherapy development plan and Guidelines for preparing a radiotherapy quality assurance programme; and Guidelines for Regulating Pathology Laboratory Good Practises and Pathology Laboratory Good Practises Manual Guidelines



We would like to take this opportunity to thank all of our partners for their continued support of this initiative, particularly the Sanofi Espoir Foundation.





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