The burden of childhood cancer in Nigeria - a focus on leukemia and lymphoma: epidemiology, biology, and health system challenges.

Childhood cancer represents an increasingly recognized priority in global health, with the World Health Organization's Global Initiative for Childhood Cancer aiming to achieve 60% survival for six index cancers by 2030. In Nigeria, leukemia and lymphoma constitute a substantial proportion of pediatric malignancies, yet outcomes remain dramatically poorer than in high-income countries. This review examines the current state of childhood leukemia and lymphoma in Nigeria, synthesizing available epidemiological data, discussing unique biological features, and analyzing the multifactorial challenges that perpetuate poor survival. Treatment abandonment exceeds 37%, mortality approaches 32%, and critical infrastructure gaps-including limited radiotherapy access, absence of bone marrow transplantation, and inadequate diagnostic capacity-compound the problem. The WHO's interventions through the Global Initiative and technical support for registry development offer frameworks for progress. Future perspectives emphasize the necessity of population-based cancer registries, expanded health insurance coverage, investment in regional diagnostic and treatment centers, and sustainable financing mechanisms to bridge the survival gap.