Common eye cancer may increase the risk of death in children of low-income families
Research led by the International Center for Eye Health (ICEH) at the London School of Hygiene and Tropical Medicine (LSHTM), has found a marked difference in the survival of children with myeloma. retinoblastoma, the most common form of eye cancer in children, among high-income children. and low-income countries.
What is retinoblastoma?
Retinoblastoma is the most common and deadly eye cancer affecting children worldwide, and early diagnosis and treatment are critical to preventing death or loss of an eye.
In high-income countries, this risk has decreased significantly over the past few decadesMortality is now rare due to robust diagnostic and therapeutic pathways, including specialist retinoblastoma centers.
What is the survival rate for retinoblastoma?
The study, the largest and most geographically comprehensive to date, looked at survival data on 4,064 children with retinoblastoma from 149 countries (classified as high-income, middle-income). , medium and low) globally. This figure is estimated to account for 50% of all new cases worldwide in 2017.
The team analyzed the three-year survival rates of these children after diagnosis, finding that more than two-fifths (40%) of children die within three years of diagnosis in low-income countriescompared with less than one in 100 (1%) in high-income countries.
Professor Matthew Burton, ICEH Director at LSHTM, said: “This is a shocking result – highlighting the inequality between high and low-income countries in terms of this disease. others are considered curable. We need to ensure that the reasons for this disparity are ascertained and that policies are in place to close this survival gap.”
Barriers to effective treatment of childhood eye cancer
Although research shows that the primary treatments for retinoblastoma (monoectomy, or nuclear transplantation and intravenous chemotherapy) are available in all countries, a number of factors may be responsible for the reduced survival rate. Previous studies have shown that low-income countries are less likely to have specialized treatment centers containing sophisticated equipment and techniques such as MRI machines and targeted chemotherapy. Awareness of the community and health workers in general is still limited, and problems accessing treatment due to travel distance and costall of which are thought to contribute to worse outcomes and increased risk of death.
Dr Ido Didi Fabian, lead author and Principal Investigator of the Global Retinoblastoma Research Group at LSHTM, said: “We’ve always known that there are differences in outcomes across countries with The income index is higher and lower, but the differences that we see in this largest study of its kind, are worrisome for children affected by retinoblastoma. Better awareness of early signs, improved access to timely diagnosis, and implementation of current guidelines aimed at children in low- and middle-income countries, are critical to improving retinoblastoma outcomes worldwide. “
Work carried out by the Retinoblastoma Network (Rb-NET), supported by ICEH, enabled 260 retinoblastoma centers worldwide to share data for the study. This collective data sharing could lead to an even more direct repository of clinical data, enhancing evidence-based guidance on the management of the condition.
Much of the available evidence for retinoblastoma comes from high-income countries, although patients in regions such as North America, Europe and Oceania account for less than 10% of all cases. bridge. The authors note that further studies are needed in low-income countries themselves to identify the causes of this global disparity and improve outcomes.
The authors acknowledge limitations of the study, including the cohort that was a sample taken from an earlier study (despite containing half of the worldwide cases for that year). The study also did not collect detailed data on treatment, such as specific treatment regimens and complications. Future studies may include these secondary analyses.
1. Global retinoblastoma outcomes study: a prospective, cluster-based analysis of 4064 patients from 149 countries – (https://www.thelancet.com/journals/langlo/ article/PIIS2214-109X(22)00250-9/fulltext )