Childhood cancer incidence, survival and mortality patterns in Argentina, 2000–2022: from the Argentine Oncopediatric Registry (ROHA)
Population-based cancer registries are essential tools for monitoring the burden of childhood cancer and guiding evidence-based public health policies. In pediatric oncology, long-term registry data are particularly valuable for evaluating survival trends, identifying inequities, and informing health system strengthening. The Argentina Oncopediatric Registry (ROHA), established in 2000, provides a unique framework for evaluating long-term trends in childhood cancer incidence, survival, and mortality. We analyzed population-based data from ROHA for children aged 0–14 years diagnosed with cancer(2000-2022).Incidence was calculated using age-standardized rates (ASR). Overall survival(OS) was estimated using standard survival analysis techniques and evaluated by calendar period, tumor group, geographic region, and Human Development Index (HDI). National mortality data were obtained from the National Statistical Office. Adolescents aged 15–19 years were excluded due to incomplete registry coverage. During the study period, 31,241 childhood cancer cases were registered, corresponding to an incidence ASR of 131 cases/million children per year, which remained stable over time. Five-year OS improved substantially, increasing from 59.7% in 2000–2004 to approximately 70% in the most recent period. The largest survival gains were observed for leukemias and central nervous system tumors. However, improvements slowed in recent years, and marked disparities persist by tumor type, geographic region, and Human Development Index level. The national age-standardized childhood cancer mortality rate per 100,000 children was 3.73 in 2021–2022 and showed a declining trend over the study period, consistent with improvements in overall survival. Over the past 25 years, Argentina has achieved meaningful progress in childhood cancer survival while maintaining stable incidence rates. Argentina's survival estimates are among the highest reported in Latin America; however, important regional and socioeconomic disparities persist. Integrating high-quality registry data with national cancer policies, social protection mechanisms, and strategies to strengthen clinical support—through the Childhood and Adolescent Cancer Protection Law and the Unique Pediatric Oncology Certificate—offers a model to improve equity, quality of care, and outcomes in Argentina and similar middle-income settings.