According to the 2023 Global Burden of Disease published recently in The Lancet, childhood cancer is now the eighth leading cause of death in children around the world, surpassing infectious diseases like measles, tuberculosis and HIV/AIDS. This reflects a broader epidemiological transition: as public health measures like immunisation reduce communicable diseases, non-communicable illnesses are emerging as a formidable threat to child survival. The situation in India is alarming: cancer is the tenth-leading cause of childhood fatalities in the country. The Lancet report states that around 17,000 Indian children died because of cancer in 2023. Other studies estimate that India records between 50,000 and 75,000 new paediatric cancer cases annually. As per the Indian Council of Medical Research’s National Centre for Disease Informatics and Research, childhood cancers accounted for 3%-5% of cancer cases in India in 2022, making it one of the highest burdens globally. This is not to suggest that the burden of cancer among children is even. The Lancet study flagged that 94% of paediatric deaths in 2023 were concentrated in low- and middle-income countries. Survival rates, however, exceed 80% in high-income nations. This underscores embedded inequities in access to care.
The factors responsible for this deepening crisis are layered. Late detection is a principal concern. The symptoms of childhood cancers often mimic common illnesses — fatigue, fever, weight loss — leading to delays in detection, especially in rural India where diagnostic infrastructure is weak. Second, the under-reporting of cases distorts the picture: cancer registries cover only a fraction of the population. Third, health system gaps — from paucity in paediatric oncology specialists to inadequate referral networks — mean that many children reach treatment centres when the disease has reached advanced stages. The economic burden compounds the medical challenges. Even when treatment is subsidised, out-of-pocket expenses on travel and accommodation and lost wages push families into destitution. Childhood cancers remain treatable, and survival improves with early diagnosis and sustained care. The policy challenge, therefore, is to move beyond viewing paediatric cancer as a peripheral issue. This rising disease burden must be integrated into national cancer control programmes, which currently screen for only three types of cancer: oral, cervical, and breast. Expansion of treatment facilities, investment in trained personnel, robust data systems and better, subsidised medication are other imperatives that the government must not lose sight of.