Epidemio-clinical profile of childhood cancers in Yaounde at the Mother and Child Center, 2016-2017

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  • Maternal and child health
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Background:
Incidence of childhood cancers ranges from 50 to 200 per million children worldwide and mortality remains high in developing countries. In Cameroon, few data are available, with 62 round cell tumors recorded in children in Yaoundé between 2004 and 2007. We described the epidemiological profile of childhood cancers in the national reference center in Yaoundé.
Methods:
We conducted a retrospective study from 2016 to 2017 in the Mother and Child Center. We collected data from registry and medical records of the pediatric oncology unit. We listed socio-demographic features, clinical stage, average consultation time (from symptoms onset to specialized consultation) and treatment features. We used Fischer Exact test with statistical significance of p<00.5.
Results:
We recorded 266 children (average of 11 new cases per month). The M/F sex ratio was 1.44, with males being mostly affected [59% (157/266); p= 0.0004]. Mean age was 6.9years (±4.6years). About 63.5% (127/200) reside out- side Yaounde. These children came from a household with a median number of 4 children (1-15) with 35% (34/95) had an unemployed or unknown/ deceased father. Diagnosis was confirmed among 75.2% (200/266) children. A hematologic malignancy was found in 65.4% (174/266). Initial clinical signs were reported among 47.7% (127/266): tumor syndrome 50.4% (64/127), intermittent fever 49.6% (63/127) and digestive signs 44.8% (57/127).The most com- mon cancers were acute lymphocytic leukemia, 18.5% (48/259), and Burkitt’s lymphoma, 16.9% (44/259). Clinical stage was reported among 49.8% (129/259) of children: 49.6% (64/129) at stage III and 20.9% (27/129) at stage IV. The median consultation time was 1.7months (IQR: 0.9-3.9months) and median confirmation time was 6days (IQR: 0-13days). Of the 266 children registered, only 2 were relapsed. Anti-carcinogenic treatment was initiated in 71.8% (179/249) of children and chemotherapy done in 94.9% (170/179). The CFR was 45.1% (120/266) with 118 children whose evolution is unknown; and 50% (57/114) of deaths occurred in the first month after consultation.
Conclusion
Most of childhood cancers were referred from outside Yaoundé and were diagnosed at advanced clinical stages with long delay of specialized consultation. Further study are needed to quantify the national burden of pediatric cancers and address improving early diagnosis and providing proven treatments.

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