Epidemiology and prognosis of childhood cancers at Gabriel-Touré Teaching Hospital (Bamako, Mali)

Cancer today is being treated as a public health problem in Africa, as in developed countries. Objective: The aim of this retrospective study was to evaluate the epidemiology and outcome of children treated in the Pediatric Oncology Unit of Gabriel Touré Teaching Hospital in Bamako (Mali), six years after it opened. Methods: Retrospective study of the files of all children aged 15 and younger diagnosed with cancer and treated by chemotherapy between January 1, 2005, and December 31, 2010. Results: The study included 690 children. Their mean age was 24 months. The time from observation of first symptoms to consultation was less than 3 months in 200 cases (29%), from 3 to 10 months in 256 (37.1%), and more than 10 months in 234 (33.9%). The five most common childhood cancers were malignant non-Hodgkin's lymphoma (NHL) (n=231, 33.5%), retinoblastoma (n=170, 24.6%), nephroblastoma (n=102, 14.8%), acute lymphoblastic leukemia (n=54, 7%), and Hodgkin's disease (n=34, 4%). Six years after the unit opened and after a mean follow-up of 3 years, we recorded 272 deaths (39.4%); at least 238 children are still alive (34.5%), with 180 cases (26.1%) lost to follow-up. Conclusion: Childhood cancer survival is still low in Mali, and the rate of loss to follow-up quite high.