Pediatric radiotherapy in low and middle income countries

Communicable diseases are still the leading cause of childhood mortality in third world countries. However, as prevention and treatment of malnutrition and infectious diseases improves, global health challenges are shifting towards combating non-communicable diseases including cancer which has high rates of mortality in children (Wilimas and Ribeiro 2001). More than two-thirds of the world’s pediatric cancers are currently diagnosed in low- and middle income countries (LMIC) (Kellie and Howard 2008). The patterns of occurrence of childhood cancer in LMIC compared to high income countries (HIC) and the lack of population-based cancer registries suggest that many patients die from undiagnosed cancer and the burden of childhood cancer is under-estimated. Children diagnosed with cancer in low-income countries (LIC) continue to have a much poorer chance of survival compared to those in HIC (Fig. 21.1). © Springer International Publishing Switzerland 2018