Kolkata: India accounts for seven out of every 10 children suffering from leukaemia in South Asia, says a new study published in Lancet magazine. The high incidence has been attributed to the country’s large population and inadequate capacity of the health system to diagnose and treat the affected children. While more than 25,000–50,000 children under the age of 15 are diagnosed with leukaemia each year, 1,000 to 1,800 children are estimated to be afflicted with the disease in West Bengal each year.
The study was conducted in SAARC countries that include India, Pakistan, Bangladesh, Sri Lanka, Afghanistan, Nepal, Bhutan and the Maldives.
Leukaemia accounts for about 30% to 40% of all childhood cancer cases across Indian cancer registries. Acute Lymphoblastic Leukaemia (ALL) makes up 70% to 75% of all childhood leukaemia cases in the country.
Estimates based on population share (West Bengal accounts for ~7% of India’s population) suggest 1,000 to 1,800 children are diagnosed with leukaemia annually in the state. Studies conducted in major Kolkata hospital registries (such as Chittaranjan National Cancer Institute and NRS Medical College) indicate that acute leukaemia accounts for approximately 39% of all paediatric malignancies in West Bengal.
“Incidence of leukaemia is much higher in Bengal and India compared to the West. Though reliable figures are not available, we get around 25,000 new cases each year. Improvements in diagnostic technology, awareness and govt initiatives have helped to identify and treat more children over the last 10 years,” said Pritam Singha Roy, consultant paediatric oncologist, Tata Medical Centre.
In India, paediatric cancer statistics focus heavily on annual new diagnoses (incidence) because national registries don’t track nationwide active cases (prevalence).
While India’s large population is responsible for the high incidence of leukaemia, other countries may have a large number of unreported and undiagnosed cases, said Narendra Agarwal, haematologist and bone marrow transplant physician at Rajiv Gandhi Cancer Institute & Research Centre. “Low awareness is primarily responsible for late diagnosis. But treatment outcomes and facilities have improved vastly across the country which should lower the mortality rate,” added Agarwal.
Countries of the South Asian Association for Regional Cooperation (SAARC) are home to approximately 600 million children aged 0–14 years, representing a quarter of the global child population, said the study.
In SAARC nations, 37,716 new childhood cancer diagnoses and 17,698 deaths were estimated in 2022, it said. India contributed 68.8% of sub-regional cases (25,939), and Pakistan contributed 20.8% (7,841). Age-standardised incidence rates differed and were greatest in Sri Lanka (10.4/100,000) and Pakistan (10.1) and lowest in Bhutan (2.3) and Bangladesh (3.7). Age-standardised mortality rates ranged from 1.1/100,000 in Bhutan to 5.2/100,000 in Afghanistan (SAARC-wide ASMR 3.5/100,000). Boys represented 57% of cases overall, with the proportion varying across countries. Leukaemia was the most common cancer in all countries (35–50%), followed by central nervous system (CNS) tumours (approximately 12% of cases). MIR ranged from 0.30 (Sri Lanka) to 0.57 (Afghanistan).
SAARC childhood cancer patterns reflect both population size and health system capacity, with a preponderance of leukaemia and marked mortality-to-incidence ratio disparities across countries, especially for CNS cancers. There is a need to have subregional cooperation to address gaps in cancer registration, equitable access to speciality care and continuity of treatment.
