Incidence and Spectrum of Childhood Tumors: A Three-Year Hospital-Based Registry Review from a Tertiary Center in Patna

Abstract Childhood cancers, though relatively uncommon, remain a leading cause of mortality and morbidity among children in low- and middle-income countries. Reliable epidemiological data from Eastern India, particularly from Bihar, remain limited. Despite the recent initiation of a population-based cancer registry (PBCR) in Bihar in 2018, its nonstatewide coverage hinders a comprehensive assessment of the disease burden and resource allocation for the entire region. To describe the incidence, spectrum, and demographic distribution of childhood tumors at a tertiary care center in Patna, Bihar, India, and to estimate the crude incidence rate (CIR) and age-standardized incidence rate (ASIR). A hospital-based cancer registry analysis was conducted at a tertiary care referral center in Patna, between January 2023 and September 2025. All newly diagnosed tumors in individuals aged 0 to 19 years (pediatric age group), confirmed histologically, cytologically, or by multidisciplinary consensus, were included. Malignancies were classified according to the International Classification of Childhood Cancer, third edition. Incidence rates were computed using the projected pediatric population of Patna, derived from the 2011 Census, and expressed as CIR and ASIR (per million person-years) with 95% confidence intervals (CI). Among 798 included patients, 756 (94.7%) had malignant and 42 (5.3%) benign tumors. The mean age at diagnosis was 7.5 ± 4.4 years, with a marked male predominance (M:F = 1.77:1). Solid malignancies (59.7%) outnumbered hematological malignancies (40.3%). The most common cancers were acute lymphoblastic leukemia (14.7%), Hodgkin lymphoma (13.4%), and retinoblastoma (11.4%). Among Patna-resident cases (n = 537), the CIR was 100.5 per million (95% CI: 93.2–107.8) and the ASIR was 106.5 per million. The highest age-specific incidence occurred in the <5-year group (29.8 per million). Embryonal tumors predominated in younger children, whereas lymphomas and bone sarcomas were more frequent among those aged 10 to <15 years. This hospital registry study at Patna reveals a substantial pediatric cancer burden, with a predominance of solid malignancies and a significant male excess. The observed high frequency of retinoblastoma and Hodgkin lymphoma, along with elevated CIR and ASIR values, underscores the urgent need for expanded PBCR coverage to accurately capture the disease burden and inform pediatric oncology planning in the region.