Childhood Cancer in Al-Najaf Governorate, Iraq: Trend Analysis from 2020 to 2023

Background: The lack of comprehensive cancer registries and underreporting of cases may further complicate efforts to assess disease patterns and implement effective control measures. Objectives: This study aims to analyze cancer trends in Al-Najaf Governorate, Iraq from 2020 to 2023, addressing gaps in local data and providing insights that could inform future healthcare strategies and resource allocations. Methods: A retrospective, cross-sectional study was conducted using data from the Middle Euphrates Oncology Center and the Statistics Department for Cancer Research at Al-Najaf General Health Directorate. The study included children younger than 18 with histologically and hematologically verified cancer from January 2020 to December 2023. Results: 417 pediatric cancer cases were documented from 2020 to 2023. A higher portion of these cases (158 cases) was documented in 2022, followed by 2023 (103 cases), 2021 (85 cases), and 2020 (71 cases). Bone cancer was the most common, particularly in 2020, 2021, and 2022, with brain cancers surpassing bone cancers in 2023. Lymphoma and blood cancers were consistently among the top three, with blood cancers peaking in 2022 (34 cases) before declining in 2023 (14 cases). The age distribution showed that most cases occurred in children older than 10 years (54%), followed by 5-10 years (27.1%) and those under 5 years (18.9%). Cancer prevalence varied by sex, with bone, blood, and brain cancers being more common in males, while thyroid, ovarian, and kidney cancers were more frequent in females. The study highlights geographic, temporal, and sex-specific differences in pediatric cancer incidence. Conclusion: Higher cancer cases were documented across Al-Najaf within 4 years. The highest number of cases was documented in 2022. The Center district of Al-Najaf consistently reported the highest number of cancer cases across all years. Bone cancer was the most common childhood cancer over the study period, with brain cancer being the most common in 2023.