Title : Emerging dynamics of pediatric oncology in India: A systematic meta-analysis of environmental toxins, nutritional deficits and global healthcare disparities
Abstract:
The landscape of pediatric oncology in India is undergoing a documented epidemiological transformation, with data-driven projections from the National Cancer Registry Programme (NCRP) forecasting a 12.8% escalation in new diagnoses by late 2026. This investigation identifies a critical dual burden characterized by the biochemical synergy between a high prevalence of nutritional co-morbidity and a "triple threat" of environmental determinants, conceptualized as the 3 P’s: Pesticides, Particulate matter, and groundwater Pollutants. A significant geographical divergence is observed: urban cohorts demonstrate a higher incidence of hematological malignancies linked to particulate matter containing benzene and nitric oxide, whereas rural populations exhibit clusters associated with parental exposure to Class-I agrochemicals and contaminated potable water sources.These anthropogenic stressors, intersecting with a prevalence of chronic malnutrition exceeding 50–60% among pediatric patients, appear to fundamentally induce DNA damage and attenuate chemotherapeutic efficacy. A formidable barrier to intervention remains the systemic underreporting in rural areas, where diagnostic lag and limited health literacy suggest that current data captures only a fraction of the true disease burden. Consequently, while childhood cancer survival in India remains suboptimal at approximately 45%—far below the 80% benchmark in High-Income Countries (HICs)—this figure likely obscures even deeper socioeconomic and regional disparities.
Within the framework of the WHO Global Initiative for Childhood Cancer (GICC), survival for the six index malignancies is further compromised by a 22% rate of therapeutic attrition. Ultimately, meeting the 2030 global mandates requires a clinical-ecological paradigm shift that integrates decentralized "Shared Care" models with rigorous environmental policy and expanded rural surveillance. Addressing the convergence of toxicological exposure and nutritional co-morbidity is vital to neutralizing the rising pediatric cancer trajectory in India.
Keywords: Pediatric ,Cancer,National Cancer Registry Programme (NCRP), Environment, WHO Global Initiative for Childhood Cancer (GICC).
