Significant Impact of Treatment Abandonment on Survival of Children With “Common and Curable” GICC Index Cancers in Sub‐Saharan Africa—A Multicenter Prospective CANCaRe Africa Study

Background The World Health Organization Global Initiative for Childhood Cancer (GICC) targets a global survival rate of 60% for childhood cancer, focusing initially on six common, curable cancers. This study describes survival rates of five of these cancers in sub‐Saharan Africa and assesses the impact of treatment abandonment (TxA). Methods This multicenter, prospective, observational cohort study included newly diagnosed children (<16 years) with Burkitt lymphoma (BL), acute lymphoblastic leukemia (ALL), Wilms tumor (WT), retinoblastoma (RB), or Hodgkin lymphoma (HL), enrolled between January and December 2022 from seven hospitals in Malawi, Ethiopia ( n = 2), Ghana, Kenya, Uganda, and Cameroon. Two‐year event‐free survival (EFS) and treatment abandonment rates were analyzed. Results Of 366 patients enrolled (median age 7.0 years, 64% males), Burkitt lymphoma was most common (30%, 108/366). Median follow‐up was 27.6 months (range: 8–37.4). Treatment abandonment occurred in 24% of patients (89/366), highest in RB patients (38%, 15/39). Overall 2‐year EFS was 40.8% ± 2.7%, improving to 59.2% ± 3.0% when TxA cases were censored. EFS rates with TxA as an event were BL 39.1% ± 5.0%, ALL 27.4% ± 4.4%, WT 51.5% ± 5.4%, RB 39.9% ± 8.0%, and HL 68.5% ± 9.3%. Conclusion Survival for common, curable childhood cancers in sub‐Saharan Africa remains low, averaging approximately 41% at 2 years, ranging from 27% (ALL) to 69% (HL). Treatment abandonment significantly impacts outcomes, affecting nearly 25% of patients. Preventing abandonment could potentially increase average survival to approximately 60%, emphasizing the need for effective intervention strategies.