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Mapping evidence on the risk factors associated with pediatric cancers in sub-Saharan Africa: a scoping review
Sehlisiwe Ndlovu1, Mbuzeleni Hlongwa2,3, Themba Ginindza2
1Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa. sehlisiwen@gmail.com.
Insights
Evidence on pediatric cancer risk factors in sub-Saharan Africa is limited, with infection-induced cancers like Burkitt Lymphoma being most common. More research is needed to control childhood cancers effectively.
Area of Science:
- Pediatric Oncology
- Epidemiology
- Public Health in Africa
Background:
- Pediatric cancers are rare and heterogeneous, complicating risk factor assessment.
- Limited evidence exists for etiological factors in childhood cancers, particularly in low- and middle-income countries (LMICs).
- Sub-Saharan Africa (SSA) faces a growing burden of non-communicable diseases, including pediatric cancers, necessitating focus on associated risk factors.
Purpose of the Study:
- To systematically map existing evidence on risk factors for pediatric cancers in sub-Saharan Africa (SSA).
Main Methods:
- A scoping review guided by Arksey and O'Malley's framework.
- Searched four electronic databases (PubMed, Health Source: Nursing/Academic Edition, Google Scholar) in December 2018 and February 2022.
- Included studies on children aged 0-15 years, adhering to PRISMA-ScR guidelines.
Main Results:
- Fifteen studies were included from 7391 retrieved articles.
- Infection-induced factors are the primary identified risk for childhood cancers in SSA.
- Burkitt Lymphoma, prevalent in tropical SSA, was the most reported cancer type. Risk factors were categorized as infection-induced, genetic, and demographic.
- Overall, evidence on pediatric cancer risk factors in SSA remains limited.
Conclusions:
- Scarcity of evidence on pediatric cancer risk factors and burden in SSA impedes effective childhood cancer control strategies.
- Developing targeted preventative measures and treatment protocols requires a comprehensive understanding of identified risk factors.
- Further research is crucial to address the knowledge gaps in pediatric oncology within the SSA region.
Background:
The rarity and heterogeneity of pediatric cancers make it difficult to assess risk factors associated with the development of cancer in this group. This also determines the quantity and quality of evidence for etiological factors linked to pediatric cancers. Evidence on the risk factors associated with pediatric cancers is scarce; however, it has been accumulating slowly over the years. As the disease burden shifts from communicable to non-communicable diseases, most of these low- to middle-income countries (LMICs) find themselves overburdened with changing health care priorities and needs. In sub-Saharan Africa, it is of major importance to pay particular attention to risk factors associated with pediatric cancer.
Objective:
To map evidence on risk factors associated with pediatric cancers in sub-Saharan Africa (SSA).
Methods:
This review was guided by Arksey and O'Malley's framework for conducting scoping reviews. Four electronic databases were searched in December 2018, and another manual search was conducted in February 2022 to include newly published eligible articles. The databases searched included PubMed and Health Source: Nursing/Academic Edition. We also searched articles from an academic search engine, Google scholar. This review included articles reporting the relevant outcomes of this study and articles reporting cancers in children in the 0-15 years age range. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews (PRISMA-ScR): checklist and explanation.
Results:
We retrieved 7391 articles from the initial database. The final number of studies that were included for data extraction was 15. Evidence from the retrieved studies suggests that most childhood cancers in the SSA region are infection-induced. The type of cancer mostly reported is Burkitt Lymphoma and is diagnosed mostly in the tropical region of SSA. The type of risk factors was divided into three types: infection-induced, genetic, and demographic risk factors. Overall, based on the articles retrieved, there was limited evidence on the risk factors associated with pediatric cancers in SSA.
Conclusion:
The limited evidence on the risk factors coupled with the lack of evidence on the true burden of these malignancies in the SSA hampers efforts to set priorities for childhood cancer control. Formulation of effective preventative (where possible) measures and treatment regimens will need proper assessment of risk factors.
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