More than 10 years ago we discussed on CHIFA the challenge of failure to diagnose retinoblastoma, thanks to HIFA member Abby White, herself a survivor of bilateral retinoblastoma. This paper and systematic review in The Lancet Global Health prompted me to look up Abby to find she is now the CEO of World Eye Cancer Hope. This charity notes that 'Every 85 minutes, a child dies from curable eye cancer. Almost all of these children (7,000 every year), live in economically less developed countries, where awareness and access to timely, appropriate medical care is very limited.' https://wechope.org/about/ What Abby has achieved, and continues to achieve, is inspirational.
Citation and selected extracts below.
CITATION: Retinoblastoma outcomes: a global perspective
Paul T Finger & Ankit Singh Tomar
Lancet Global Health 2022; Published:January 27, 2022 DOI:https://doi.org/10.1016/S2214-109X(21)00598-2
SELECTED EXTRACTS
Retinoblastoma is the most common paediatric eye cancer, and is typically curable through early diagnosis and protocol-based management. In fact, advanced medical care delivery in high-income regions has provided excellent rates of survival, and globe and vision salvage. Unfortunately, these outcomes are not true to medical systems in middle-income and low-income regions. Low-income or middle-income countries in Asia and Africa contribute a large majority of retinoblastoma cases, including many advanced retinoblastoma tumours at presentation, resulting in dismal patient outcomes. In The Lancet Global Health, the systematic review and meta-analysis by Emily Wong and colleagues [ https://doi.org/10.1016/S2214-109X(21)00555-6 ] provides strong evidence that overall survival, globe salvage, and visual outcomes are compromised due to disparities in socioeconomic and related health-care factors...
Current estimates suggest that more than half of all retinoblastoma cases come from the Asia Pacific region and nearly a quarter come from Africa. Of individual countries, India has the highest retinoblastoma incidence... Delay in diagnosis is more common in low-income countries, resulting in children presenting with advanced retinoblastoma (ie, combinations of proptosis, red eye, orbital cellulitis, and extraocular retinoblastoma) and thus poorer outcomes.
Wong and colleagues explored the reasons for delayed presentation and found that low awareness among parents, an inability to pay for care, and a scarcity of ophthalmic examination resources at paediatricians' offices all contributed to delayed recognition of retinoblastoma symptoms. In addition, remote tertiary care facilities, gender bias, religious beliefs, and social stigma can delay or obstruct early diagnosis and prompt treatment. ..
Treatment has shifted towards vision salvage and rehabilitation in resource-rich countries, whereas resource-poor countries still struggle to provide access to primary treatment to save lives...
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Neil Pakenham-Walsh, HIFA Coordinator, neil@hifa.org www.hifa.org
