Global, regional, and national survey on burden and quality of care index (QCI) of childhood cancer: A systematic analysis of the Global Burden of Disease Study 1990-2019 (Preprint)

BACKGROUND Improving the quality of care is vital to enhance outcomes for childhood cancer patients. In this study, we estimated the temporal and geographic distribution of quality of childhood cancer care at global, regional, and country level. OBJECTIVE Childhood cancer was a concerning global health issue threatening the lives and health of children and adolescents, among which leukemia and brain and central nervous system tumors are the most common tumors. World Health Organization (WHO) proposed a global initiative in 2018 with the aim to save one million cancer children in the next 10 years. Improving the quality of care is vital to enhance outcomes for childhood cancer patients. However, the inequality of childhood cancer care was seldomly assessed. METHODS Our research collected the data from the Global Burden of Disease 1990-2019 database, and constructed the Quality of Care Index (QCI) for children with leukemia and brain and central nervous system (CNS) tumors. Estimated average percentage change (EAPC) were calculated to quantify the temporal trends of QCI. RESULTS Childhood cancers’ QCI was positively correlated with social development level. From 1990 to 2019, QCI of leukemia was observed a decreasing trend in the middle and low-middle SDI regions. Boys’ care quality was lower than girls and the gender disparity was expanding. CONCLUSIONS The results emphasized the urgent need to focus on the vulnerable areas and populations and apply integrated measures to increase access to quality health services to improve the health outcomes for childhood cancer patients.