Marking Childhood Cancer Awareness Month

September 25, 2023January 4, 2024 Danielle Norton

Childhood Cancer in Ireland

Approximately 200 children are diagnosed with cancer each year in Ireland.1 Average survival rates continue to increase and are at 80%, however, it remains as the leading cause of death in children over the age of 12 and treatment leaves most survivors with long-term side effects. The Irish Cancer Society is one of many organisations marking childhood cancer awareness month this September, to support the families coping with this disease and work to improve treatments and support available to them in Ireland.

The incidence of cancer in children increases with age, to a moderate risk by 15 years (1 in 450) to a substantial risk by the age of 20 (1 in 320).3 This incidence is comparable to other childhood illnesses that are seen as more common, such as diabetes and epilepsy. The small numbers of children diagnosed each year makes it a challenge to detect in primary care by a GP who may only see one case in their career; however, the individual risk for each child is quite high, and GP’s need to be equipped with the educational resources and guidance to make detection and referral as streamlined as possible.

Early Detection

The early detection and diagnosis of childhood cancer matters.

While childhood cancer is not preventable via lifestyle interventions, as is the case in many adult cancers, the early detection of cancer is the best way to help get the treatment required. Early detection, timely diagnosis and access to treatment and support are key in ensuring the least harsh treatment protocol can be used in each patient according to their needs. The later the cancer is diagnosed, the higher the chances that more intensive combinations of treatments will be required thereby increasing the burden of late effects in survivors. Indeed, research has shown that this is an issue in other European countries.4, 5 A protracted pathway to diagnosis reduces the health-related quality of life in adolescents and young adults, with increased mental health difficulties also experienced in this vulnerable group.6 As in the case in cancer care, the earlier it is diagnosed, the better.

Primary care is generally the first instance where childhood cancer can be detected. There is a challenge in diagnosis due to the diffuse clusters of symptoms that are often non-specific as well as the rarity of the disease. There is also no referral guidance in place in Ireland for GPs to equip them with the information needed to refer patients appropriately, and what symptoms require immediate or urgent referral for further testing. In the absence of this, helpful considerations include:

Not to disregard the concerns or the “gut feeling” of parents or the practitioner
3 visits over 3 months with the same collection of cancer has a higher risk of it being cancer, and that
Contacting a specialist in paediatric haematology/ oncology is a good step when the GP is concerned.7

Referral guidance for primary care is a key element in the early detection of childhood cancer and campaigns to increase awareness works. The HeadSmart campaign in the UK to increase awareness of brain tumour symptoms in children, as well as amplifying existing referral guidance, decreased the diagnostic timeline from 14.4 weeks to 6.7 weeks, now one of the shortest timelines in the world.8

Excellent guidance exists as exemplars for the Irish referral pathway system: The UK have NICE Guidance with supported documentation from the Childhood Cancer and Leukaemia Group (CCLG).9 CCLG are also a partner in the “Childhood Cancer Smart” project,10 which aims to reduce the diagnostic timelines for childhood cancer by addressing delays and improving awareness of the symptoms of cancer in young people. Evidence-based measures to improve the early detection of childhood cancer includes referral pathways and guidance in primary care, training for healthcare professionals to detect the signs and symptoms of childhood cancer, and campaigns to increase the awareness of symptoms among the public.

Childhood Cancer Awareness Month

This September, the Irish Cancer Society wants to highlight the solutions required to prioritise the early detection of childhood cancer. We continue to support primary care practitioners to empower them and ensure they have access to the referral guidance, educational resources and pathways required to get children diagnosed as soon as possible. Childhood cancer, while a rare disease, is life-threatening and leaves profound effects on the child and their family when diagnosed. This Irish Cancer Society provides many supports to these families, including through our advocacy efforts for this group and in the services we provide. For more info, see https://www. cancer.ie/cancer-information-andsupport/childrens-cancer

References available on request