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. 2022 Dec;28(12):2563-2572.
doi: 10.1038/s41591-022-02109-2. Epub 2022 Nov 20.

Global and regional estimates of orphans attributed to maternal cancer mortality in 2020

Florence Guida  1 , Rachel Kidman  2 , Jacques Ferlay  3 , Joachim Schüz  3 , Isabelle Soerjomataram  3 , Benda Kithaka  4 , Ophira Ginsburg  5 , Raymond B Mailhot Vega  6 , Moses Galukande  7 , Groesbeck Parham  8 , Salvatore Vaccarella  3 , Karen Canfell  9 , Andre M Ilbawi  10 , Benjamin O Anderson  10 , Freddie Bray  3 , Isabel Dos-Santos-Silva  11 , Valerie McCormack  12
Affiliations

Global and regional estimates of orphans attributed to maternal cancer mortality in 2020

Florence Guida et al. Nat Med. 2022 Dec.

Abstract

Despite women being disproportionally affected by cancer deaths at young ages, there are no global estimates of the resulting maternal orphans, who experience health and education disadvantages throughout their lives. We estimated the number of children who became maternal orphans in 2020 due to their mother dying from cancer in that year, for 185 countries worldwide and by cause of cancer-related death. Female cancer deaths-by country, cancer type and age (derived from GLOBOCAN estimates)-were multiplied by each woman's estimated number of children under the age of 18 years at the time of her death (fertility data were derived from United Nations World Population Prospects for birth cohort), accounting for child mortality and parity-cancer risk associations. Globally, there were 1,047,000 such orphans. Over half of these were orphans due to maternal deaths from breast (258,000, 25%), cervix (210,000, 20%) and upper-gastrointestinal cancers (136,000, 13%), and most occurred in Asia (48%: India 15%, China 10%, rest of Asia 23%) and Africa (35%). Globally, there were 40 new maternal orphans due to cancer per 100,000 children, with a declining trend with a higher Human Development Index (range: 121 in Malawi to 15 in Malta). An estimated 7 million children were prevalent maternal orphans due to cancer in mid-2020. Accelerating the implementation of the World Health Organization's cervical and breast cancer initiatives has the potential to avert not only millions of preventable female cancer deaths but also the associated, often-overlooked, intergenerational consequences of these deaths.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Percentage distribution of site-specific cancer deaths giving rise to new maternal orphans due to cancer in 2020, by region around the globe.
Cancer codes (ICD-10) included in each of the 14 cancer groups are listed in Extended Data Table 3.
Fig. 2
Fig. 2. Percent distribution of maternal orphans due to cancer (worldwide) by mother’s age at the time of death and by type of cancer death within each category.
Cancer codes (ICD-10) included in each of the 14 cancer groups are listed in Extended Data Table 3. Percentages on top of bars are % of maternal orphans due to cancer in each age group. Percentages within bars are % of maternal orphans arising from each cause of cancer-related death within each maternal age at death group.
Fig. 3
Fig. 3. World map of new maternal orphans due to cancer in 2020.
a, Number of new maternal orphans due to cancer per 100 cancer deaths in women in 2020. b, Number of new maternal orphans due to cancer per 100,000 children in 2020. NA: Not available.
Fig. 4
Fig. 4. Number of new maternal orphans due to cancer per 100,000 children and the mean age at orphaning versus a country’s human development index (HDI).
a, Number of new maternal orphans due to cancer per 100,000 children, in 2020, plotted against a country’s human development index. b, Average age at orphaning at their mother’s death, in 2020, plotted against a country’s HDI. Ten of 185 countries/territories are not included as they do not have an HDI value. They represent 10,000 new maternal orphans due to cancer in 2020.
Extended Data Fig. 1
Extended Data Fig. 1. Distribution of maternal age at death when new maternal cancer orphans occurred, and of the type of cancer-related death within each age-at-death band.
Data for six world regions: (a) Africa, (b) Asia, (c) Europe, (d) Northern America, (e) Latin American and the Caribbean and (f) Oceania.
Extended Data Fig. 2
Extended Data Fig. 2
Cumulative risk (%) of death from cancer in women at ages 15–54 years (ages when 92% of maternal orphans due to cancer arise), 2020.
Extended Data Fig. 3
Extended Data Fig. 3
Mean number of living children < 18 years according to women’s age in 2020, by world region.
Extended Data Fig. 4
Extended Data Fig. 4. New maternal orphans due to cancer per 100 female cancer deaths by a country’s human development index for (A) cancer deaths at any age and (B) restricted to those occuring under age 50 years.
10 of 185 countries/territories are not included as they do not have a HDI value. They represent 10,000 new maternal orphans due to cancer in 2020.
Extended Data Fig. 5
Extended Data Fig. 5
Number of new maternal orphans due to cancer per 100,000 children vs per 100 female cancer deaths for each country.
See this image and copyright information in PMC

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