Stakeholders link delayed childhood cancer diagnosis to symptoms overlap, ignorance

•NISPO seeks cancer funds, specialised pediatric oncology centres
• Experts urge free cancer treatment for children

Stakeholders have identified a combination of ignorance and overlap of symptoms as major contributors to delayed or missed diagnoses in childhood diseases.

They argue that the symptoms of childhood cancers often resemble those of more familiar ailments, leading to high rates of underdiagnosis and suboptimal care.

World Health Organization (WHO) highlighted the stark contrast between high- and low-income countries. While over 80 per cent of children with cancer are successfully treated in high-income countries, fewer than 30 per cent of children in low- and middle-income countries (LMICs) survive.

WHO attributes these disparities to delayed diagnosis, misdiagnosis, and barriers to accessing appropriate care. WHO estimates 400,000 children and adolescents aged 0 to 19 are diagnosed with cancer yearly with the most common types including leukaemias, brain tumours, lymphomas, and solid tumours like neuroblastoma and Wilms tumour.

Every February 15th is celebrated as International Childhood Cancer Day (ICCD) and this year’s theme “Inspiring Action,” focuses on actionable solutions, highlighting collaborative efforts and innovative initiatives to overcome the challenges faced by children with cancer worldwide.

The Secretary, Nigerian Society of Pediatric Oncology (NISPO), Dr Morufat Ogundeyi, explained that a major obstacle in the early detection of childhood cancer is the symptom overlap in childhood illnesses.

“Many parents and caregivers struggle to differentiate between the symptoms of cancer and those of regular childhood diseases. This often leads to delayed or missed diagnoses, underdiagnosis, and suboptimal care, which worsens the prognosis for the child,” she explained.

However, Ogundeyi revealed that various studies conducted in different parts of the country show a higher incidence of pediatric cancers in the Southern region of Nigeria compared to the North.

The association raised concerns about the lack of adequate diagnostic tools, such as molecular diagnostics, CT scans, MRIs, and PET scans, which are often too expensive and inaccessible to most families. “Without these critical resources, it is difficult to diagnose childhood cancers at an early stage, which severely limits treatment options and outcomes.”

Other challenges include the low prioritisation of childhood cancer in healthcare policies, inadequate infrastructure, and the lack of dedicated pediatric oncology wards in most institutions.

The NIPSO secretary further stated that the shortage of trained healthcare professionals, including pediatric oncologists, radiologists, and oncology nurses exacerbates the problem. “Many children are unable to access these essential treatments, which forces families to abandon care,” she added.

According to NISPO, one of the most pressing concerns is the lack of a population-based pediatric oncology tumour registry. “There is only one functional registry in Africa, most others operate out of tertiary hospitals, which makes it difficult to plan and provide effective care,” Ogundeyi said.

To address these challenges, NISPO called for the establishment of specialised pediatric oncology centres with adequate infrastructure, the creation of a national pediatric oncology referral system, and the introduction of a national pediatric oncology tumour registry to improve data collection and patient outcomes.

The association also emphasised the need to increase the number of trained healthcare professionals, particularly pediatric oncologists, nurses, and oncology pharmacists.

Furthermore, NISPO called for the creation of a national cancer fund and improved health insurance systems to provide financial assistance to families facing the economic burden of cancer treatment.

Ogundeyi urged the government to negotiate with pharmaceutical companies to reduce the cost of essential childhood cancer drugs and fund research into the prevalence and patterns of childhood cancers in Nigeria to inform better policy decisions.

She also highlighted the importance of addressing infectious diseases through childhood immunization programmes, including vaccines for Hepatitis B and HPV, and the eradication of malaria, which could ultimately reduce the overall cancer burden.

The Head of Management of Okapi Children Cancer Foundation, Dr Ozy Okonokhua, called on the Federal Government to prioritise childhood cancer treatment by making it free for all children diagnosed with the disease.

Okonokhua told The Guardian that the financial burden on families is one of the most significant challenges in treating childhood cancer, particularly for those from economically disadvantaged backgrounds.

He argued that if the government fully funds childhood cancer treatment, it would encourage more parents to bring their children for early treatment, potentially improving survival rates.

The doctor stressed that the treatment of childhood cancer should not be treated as part of a broad cancer relief initiative but should be given a distinct, focused approach.

He pointed out that while the government has made strides in providing cancer treatment for adults, there has been insufficient attention to childhood cancer.

Okonokhua proposed that if full funding was not feasible, the government should heavily subsidise the cost of treatment to make it more accessible for families.

He further noted that the current cancer relief fund, though helpful, often places greater emphasis on adult cancers. He argued that there needs to be a dedicated initiative for childhood cancer, similar to the programs implemented for treating other childhood diseases like malaria and typhoid in the past.

He explained that by providing free or subsidised treatment specifically for children with cancer, the government could make a significant difference in addressing the rising incidence of childhood cancer across the country.

While advocating for improved government intervention, he noted that the foundation has been actively involved in raising awareness about childhood cancer, conducting sensitisation campaigns in schools, and providing free medical screenings in communities to help with early detection in the fight against childhood cancer.

Speaking, the Matron of the Pediatric-Oncology Unit at the University of Abuja Teaching Hospital (UATH), Stella Omokaro, pointed out that the most pressing challenge facing families and healthcare professionals in the management of childhood cancer in Nigeria is the financial burden.

Omokaro explained that the financial strain often forces some families to stop seeking treatment altogether. “Some families, unable to afford treatment, make the difficult decision to take their child home, where they may stop receiving care,” she said.

Omokaro also called for further government support in alleviating the financial burden on families. She suggested that the government should take on the responsibility of covering medication costs for children with cancer.

“If the government starts taking care of the medication bills, then the parents will be left with other things like the feeding and toiletry of the child, which will make it easier,” she said.