Mortality Burden Among Egyptian Children And Adolescents With Cancer: A Bare-Knuckle Fight.

Incidence rates of pediatric cancer tend to increase over the years, putting a burden on the healthcare system, particularly in low-middle-income countries (LMICs), which may be attributed to the mortality rates. We aimed to retrospectively evaluate the frequency of deaths among children diagnosed with cancer at Ain Shams Pediatric Oncology Unit in the last 10 years and to assess possible aetiology and risk factors of fatalities. A total of 500 children and adolescents with cancer were recruited, and data were collected and analyzed regarding the demographic, clinical, and disease characteristics and death-related features, timing, and possible causes. At the time of the study, the median (IQR) age was 4.25 (2.5 – 8.0) years, with male predominance (54.4% vs 45.6%). 357 (71.5%) were alive and 143 (28.5%) were dead. Of the one hundred forty-three patients who died, 37 (25.4%) died within 30 days after diagnosis (early death), 88 (61.54%) had haematological malignancies, and 55 (38.46%) had solid tumours. The highest mortality was recorded among patients with acute lymphoblastic leukaemia (31.8%), followed by acute myeloid leukaemia. Moreover, early death was significantly higher among those with haematological malignancy (34.1%) than among patients with solid tumours (12.7%) (P=0.005). The most common cause of death among patients with haematological malignancy was infection, while among those with solid tumours was the primary disease (P=0.003). We concluded that childhood cancer mortality is relatively better than previous published Egyptian studies, but lower than international figures in developed countries.