Potential years of life lost by major childhood cancer deaths in Bombay.
BACKGROUND
Over the last two decades mortality from childhood cancers has declined in the West, possibly due to advances in chemotherapy. Unfortunately, poor countries cannot afford these drugs as they are costly and scarce. We undertook this study in Bombay to help us make rational choices in this area.


METHODS
We studied the mortality, incidence and years of potential life lost by premature death from specific cancers in children under 15 years of age.


RESULTS
Leukaemia accounted for 30% to 50% of premature life lost by death from cancers regardless of gender or age, i.e. if such loss was avoided by timely diagnosis and therapy, up to 50% gain of person-life would occur. It constituted nearly one-third of the childhood cancers, with age-adjusted rates comparable with American blacks and whites in boys, but less in girls. Incidence and decline of mortality due to leukaemia from 1964 was lower in girls than in boys.


CONCLUSIONS
A focus on leukaemia treatment would increase productive person-life by nearly 50%. A triaging system might be the best method for allocating treatment till data on cost of such therapy are available. There is a need to increase morphological diagnoses in girls. Concentrating on treating girls with leukaemia older than 5 might contribute most in terms of gain in human potential and would be a cost-effective use of scarce resources.
Krishnamurthy
S
S
Department of Community Oncology, Shirdi Sai Baba Cancer Hospital and Research Centre, Karnataka, India.
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D015276:Health Care Rationing; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009369:Neoplasms / Q000401:mortality* / Q000628:therapy; D011159:Population Surveillance; D014504:Urban Health; D026712:Value of Life