Pediatric hematology-oncology outreach for developing countries

Pediatric cancer is highly curable in developed countries. Cure rates approach 90% for some tumors, and the overall cure rate has reached 75%.(11) In developing countries, however, cure rates may reach only 25% at best. There are an estimated 210,000 new cases of childhood cancer per year worldwide, and more than 80% of these cases occur in countries that lack the resources to provide treatment.(7) As shown in Figure 1, this disparity results in a worldwide cure rate of only 33% for childhood cancer. Additionally, as infant mortality and death from infectious diseases have decreased in developing countries, cancer has become a more prominent cause of childhood mortality. In Latin America, Thailand, India, and China, cancer has become a leading cause of death among children 5 to 15 years old. (14) To address these inequities, institutions and organizations throughout the world are initiating international outreach programs. These efforts are often fragmented, and little information about them is available in the medical literature. This article describes several initiatives throughout the world, outlines the International Outreach Program at St. Jude Children's Research Hospital, and offers some suggestions for programs aimed at addressing this significant problem.