Clarity on Global Disparity

Healthcare disparities are a major issue globally, with large portions of the world’s population facing preventable obstacles to high-quality care. Now, socioeconomic status has been highlighted as a major risk of childhood death from retinoblastoma in research from the London School of Hygiene and Tropical Medicine, London, UK (1). In fact, data published in The Lancet Global Health shows that children in low-income countries are 16 times more likely to die from retinoblastoma – the most common eye cancer – in the first three years following diagnosis.

This is the first assessment of global disparities relating to retinoblastoma. Due to the cancer’s rarity, previous data on the disease were quite sparse and heavily focused on high-income countries in North America, Europe, and Oceania, although over 80 percent of patients are located in low- and middle-income countries. In comparison, this study is remarkably extensive, with data gathered from 4,064 patients in 149 countries; it is estimated to include half of all new global retinoblastoma cases in 2017.

Death from retinoblastoma is rare in high-income countries – but the cancer’s 99.5 percent survival rate drops to almost 50 percent in low-income countries. This is not due to lack of essential treatment, because treatment is available in almost all countries and participating centers. So why the disparity?

Early diagnosis and treatment are crucial to retinoblastoma survival, yet patients in countries with poor economic standing tended to present late with advanced disease. Increased awareness of early symptoms of retinoblastoma is needed in low- and middle-income countries so that parents and families can recognize the need to see a clinician when symptoms arise, improve access to prompt diagnosis, and fully engage with existing treatment pathways.