Objectives/Purpose: Cancer burden among Indigenous children and young people remain underreported globally. This systematic review and meta-analysis summarises global evidence on cancer incidence, mortality and survival in this population.
Sample and Setting: Studies published in English since 2013 reporting cancer incidence, mortality, or survival among Indigenous populations aged 0–24 years were obtained and selected using search strategy based on CoCoPop framework.
Procedures: Five databases (CINAHL, PubMed, PsycINFO, Web of Science and Embase) were searched following PRISMA guidelines. Both qualitative and Meta-analysis were conducted to describe and to estimate pooled outcomes. The review was registered with PROSPERO (CRD42024586256).
Results: Thirty-seven studies involving 8,575 Indigenous children and young people aged 0-24 years from Australia, Canada, the USA and South America were included in the review. Most studies reported data from population-based cancer registries with standardised diagnostic codes.
Among Indigenous children (0–19 years), leukaemia, CNS tumours, and lymphoma were comprised two thirds of all cancer diagnosis, while germ cell tumours and carcinomas were more common in adolescents and young adults (15–24 years). Considerable heterogeneities were identified among the studies reporting age groups, cancer types, analytic methods which limited direct comparisons. Many studies having sufficient cases reported higher cancer incidence among Indigenous children and adolescents compared to non-Indigenous peoples.
Meta-analysis of five articles (n=703) from Australia, Canada, and the USA showed a 55% higher mortality risk (adjusted hazard ratio [aHR]= 1.55, 95% CI: 1.12, 2.15). For cancer other than leukemia and CNS tumours, Australia Indigenous children had an 84% higher mortality risk compared to non-Indigenous children (HR of 1.84, 95% CI: 1.44, 2.35).
Conclusion and clinical implications: Results of this review highlight consistently higher cancer incidence and poorer survival among Indigenous young people, warranting further investigation into disparities in cancer care.