Pediatric central nervous system cancers in the democratic People's Republic of Korea

Purpose: Central nervous system (CNS) cancers rank as the most frequent solid tumors and the leading cause of cancer-related deaths in children and adolescents. There is less information available about pediatric brain and CNS tumors in low-income and middle-income countries, suggesting a lack of surgical accessibility or limited capacity to treat these conditions. In this study, we chose to study the epidemiology of CNS cancers in the Democratic People's Republic of Korea (DPRK). Methods: We extracted the prevalence, incidence, deaths, and disability-adjusted life years (DALYs) associated with CNS cancers in individuals under the age of 20 from the 2017 Global Burden of Disease study from the Institute for Health Metrics and Evaluation. DALYs, which signify the number of healthy life years lost due to ill health, disability, or early death. Economic impact was calculated from DALYs. Conclusions: Given the large burden of brain and CNS cancers among all pediatric cancers in the DPRK, scaling up and strengthening surgical services for children is an essential component to improving care of pediatric CNS cancers in the DPRK. Childhood cancers are time sensitive, and early diagnosis and treatment are vital in ensuring improved survival for the vulnerable pediatric cancer patient population. As surgical treatment can often prolong lives and even prevent premature deaths from these cancers, further analysis of current surgical capacity can inform the path to meeting these critical pediatric surgical needs.

Key-words:

Central nervous system cancers - Democratic People's Republic of Korea - neurosurgery - pediatrics

Financial support and sponsorship

Nil.

Publikationsverlauf

Eingereicht: 09. April 2021

Angenommen: 12. Juni 2021

Artikel online veröffentlicht:
16. August 2022

• References

• 1 GBD 2017 Childhood Cancer Collaborators. The global burden of childhood and adolescent cancer in 2017: An analysis of the global burden of disease study 2017. Lancet Oncol 2019;20:1211-25.
• 2 Ezzat S, Kamal M, El-Khateeb N, El-Beltagy M, Taha H, Refaat A, et al. Pediatric brain tumors in a low/middle income country: Does it differ from that in developed world? J Neurooncol 2016;126:371-6.
• 3 Global Initiative for Children's Surgery. Optimal resources for children's surgical care: Executive summary. World J Surg 2019;43:978-80.
• 4 Optimal Resources for Children's Surgical Care: I. Guidelines for Different Levels of Care. Available from: https://www.globalchildrenssurgery.org/wp-content/uploads/2019/03/OReCS-Supplrement-1.pdf. [Last accessed on 2020 Jul 13].
• 5 Koustuv Dalal, “Economic Burden of Disability Adjusted Life Years (DALYs) of Injuries,” Health 7 (April 27, 2015): 494, https://doi.org/10.4236/health.2015.74058; Park, K.; Pacheco Pardo, R.; Ernst, M.; Kim, M.E. Injuries in the DPRK: The Looming Epidemic; Korean Chair VUB: Brussels, Belgium, 2019.
• 6 National Accounts Main Aggregates Database, 2017, (Select all Countries, “GDP, Per Capita GDP - US Dollars”, and 2016 to generate table), United Nations Statistics Division. https://unstats.un.org/unsd/snaama/basic [Last accessed on 2020 Aug 21].
• 7 Kline NE, Sevier N. Solid tumors in children. J Pediatr Nurs 2003;18:96-102.
• 8 Dewan MC, Baticulon RE, Rattani A, Johnston JM, Warf BC, Harkness W. Pediatric neurosurgical workforce, access to care, equipment and training needs worldwide. Neurosurg Focus FOC 2018;45:E13.
• 9 Mullapudi B, Grabski D, Ameh E, Ozgediz D, Thangarajah H, Kling K, et al. Estimates of number of children and adolescents without access to surgical care. Bull World Health Organ 2019;97:254-8.
• 10 Lalchandani P, Dunn JC. Global comparison of pediatric surgery workforce and training. J Pediatr Surg 2015;50:1180-3.
• 11 Hamad D, Yousef Y, Caminsky NG, Guadagno E, Tran VA, Laberge JM, et al. Defining the critical pediatric surgical workforce density for improving surgical outcomes: A global study. J Pediatr Surg 2020;55:493-512.
• 12 Medium Term Strategic Plan for the Development of the Health Sector in DPRK. Available from: https://extranet.who.int/countryplanningcycles/sites/default/files/planning_cycle_repository/democratic_peoples_republic_of_korea/dpr_korea_medium_term_strategic_plan_2016-20.pdf. [Last accessed on 2020 Jul 25].
• 13 Optimal Resources for Children's Surgical Care: I. Guidelines for Different Levels of Care. Available from: https://www.globalchildrenssurgery.org/wp-content/uploads/2019/03/OReCS-Supplrement-1.pdf. [Last accessed on 2020 Jul 25].