China records rise in survival prospects for child and adolescent cancer patients

The survival prospects for child and adolescent cancer patients in China have improved significantly, with their five-year survival rate reaching 77.2 percent overall, and rates for certain cancer types exceeding international standards, according to a study published in the medical journal The Lancet recently.

The study, led by researchers from Beijing Children's Hospital affiliated with Capital Medical University, also identified regional survival disparities and recommended measures, including establishing regional pediatric cancer centers, standardized referral systems, and AI-assisted diagnostics to help bridge these gaps.

Ni Xin, president of the hospital and the study's lead author, noted that this is the first systematic analysis of cancer survival trends among Chinese patients aged 19 and younger. The research covered nearly 95,200 cases diagnosed between 2018 and 2020.

Findings indicate that the five-year survival rate was 77.8 percent for children under 14, and 75.3 percent for adolescents aged 15 to 19. Girls had a higher survival rate of 79 percent compared to boys at 75.8 percent.

Notably, China's five-year survival rates for the six childhood cancers prioritized under the WHO Global Initiative for Childhood Cancer 2030 have all surpassed 80 percent, with the highest reaching 93.8 percent. This is well above the WHO's 60 percent target.

These six cancers — acute lymphoblastic leukemia, Burkitt lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumor, and low-grade glioma — account for 50 to 60 percent of all childhood cancers and are considered highly treatable with proven therapies.

According to the researchers, China has made substantial progress in survival rates for common childhood cancers such as leukemia and lymphoma, with outcomes for neuroblastoma, retinoblastoma, and Hodgkin lymphoma now approaching those in high-income countries.

They attributed these gains to sustained reforms in healthcare security, improved cross-provincial medical reimbursement, policies supporting patients with serious illnesses, standardized treatment protocols, and the development of a collaborative treatment network.

However, the study also highlighted persistent survival gaps linked to regional socioeconomic development. The overall cancer survival rate ranged from 72.6 percent in regions of low development to 84.9 percent in high development regions. The disparity is even more pronounced among adolescents than among younger children.

About 23.5 percent of patients sought initial treatment outside their home region, and these patients faced significantly lower mortality risks compared to those treated locally. The survival difference between patients who traveled across provinces and those who did not reached up to 18.2 percent, according to the study.

"These findings highlight China's contribution to global efforts to meet the WHO Global Initiative," the study said. "Despite this achievement, substantial regional disparities in survival remain, driven by structural and multifaceted factors including uneven healthcare resource distribution, financial hardship, and deficiencies in insurance and social support systems."

To address these inequalities, the study proposed targeted measures such as establishing regional pediatric cancer centers, standardizing referral pathways, and deploying artificial intelligence to enhance diagnostics in resource-limited settings.

"These efforts are especially important for cancers with considerable unmet needs, including leukemias, hepatic tumors, malignant bone tumors, and soft tissue sarcomas, particularly among adolescents," it said. "Health systems should also ensure continuity of care during the transition from childhood to adolescence and from adolescence to adulthood," it added.