Two-year overall survival of children with cancer between 2015 and 2021 in Zimbabwe

Background: Childhood cancer survival in low- and middle-income countries (LMICs) is low, and data are limited. Aim: We investigated 1-year and 2-year overall survival (OS) of children diagnosed with cancer in Zimbabwe between 2015 and 2021. Setting: Retrospective childhood cancer data from 2015 to 2022 were collected from KidzCan’s database. Methods: Demographic data, cancer diagnosis and performance status were collected to determine OS 2 years post-cancer diagnosis. Data were analysed using Kaplan-Meier survival curves and Cox regression analysis. Results: A total of 514 from 1090 childhood cancer cases were analysed (576 cases were excluded because of missing data). The mean age at diagnosis was 5.0 years (standard deviation 3.8), with a male-to-female ratio of 1:1.25. One-year OS was 38% (mean 7.5 months; 95% confidence interval [CI] [7.1–8.0]) and 2-year OS was 17.3% (mean 10 months; 95% CI [9.7–11.4]). Male cases (21.9%) had a better 2-year OS compared to female cases (10%) (p = 0.012). Lymphoma and retinoblastoma had the best 2-year OS (29% and 28%, respectively) (p = 0.002). Children active at diagnosis (28%) had an improved 2-year OS than those who were frail (11.5%) and bedridden (13%) (p < 0.001). Conclusion: Sex, cancer diagnosis and performance status were associated with OS. Long-term follow-up is essential to determine long-term outcomes for all children treated with cancer. This study highlights the vital role of civil society organisations in supporting the establishment of a local childhood cancer registry. Contribution: This study will significantly contribute to understanding childhood cancer survival in LMICs like Zimbabwe and provide a baseline for future research.