We estimate that there will be 13·7 million new cases of childhood cancer globally between 2020 and 2050. At current levels of health system performance (including access and referral), 6·1 million (44·9%) of these children will be undiagnosed. Between 2020 and 2050, 11·1 million children will die from cancer if no additional investments are made to improve access to health-care services or childhood cancer treatment. Of this total, 9·3 million children (84·1%) will be in low-income and lower-middle-income countries. This burden could be vastly reduced with new funding to scale up cost-effective interventions. Simultaneous comprehensive scale-up of interventions could avert 6·2 million deaths in children with cancer in this period, more than half (56·1%) of the total number of deaths otherwise projected. Taking excess mortality risk into consideration, this reduction in the number of deaths is projected to produce a gain of 318 million life-years. In addition, the global lifetime productivity gains of US$2580 billion in 2020–50 would be four times greater than the cumulative treatment costs of $594 billion, producing a net benefit of $1986 billion on the global investment: a net return of $3 for every $1 invested. In sum, the burden of childhood cancer, which has been grossly underestimated in the past, can be effectively diminished to realise massive health and economic benefits and to avert millions of needless deaths.

我们估计，到2020年至2050年，全球将新增13·700万例儿童期癌症。以当前的卫生系统绩效水平（包括获得和转诊），这些儿童中将有6·100万（44·9％）是儿童。无法诊断。如果不进行任何其他投资来改善获得医疗保健服务或儿童癌症治疗的机会，那么从2020年到2050年，将有11·100万儿童死于癌症。在这一总数中，将有9·300万儿童（84·1％）在低收入和中低收入国家。借助新的资金来扩大具有成本效益的干预措施，可以大大减轻这种负担。同时全面扩大干预措施，可以避免在此期间患癌症的儿童死亡6·200万，否则预计的死亡总数将超过一半（56·1％）。考虑到过高的死亡风险，这种死亡人数的减少预计可增加3.18亿生命年。此外，到2020-50年，全球终生生产力增加2.58万亿美元，将是累积治疗费用5,940亿美元的四倍，全球投资产生的净收益为1,860亿美元：每1美元的净收益为3美元投资。总而言之，可以有效地减轻过去被严重低估的儿童癌症负担，以实现巨大的健康和经济利益并避免数百万不必要的死亡。2020-50年，全球终生生产力增加25800亿美元，将是累积治疗费用5940亿美元的四倍，全球投资产生的净收益为16600亿美元：每投资1美元，净收益为3美元。总而言之，可以有效地减轻过去被严重低估的儿童癌症负担，以实现巨大的健康和经济利益并避免数百万不必要的死亡。2020-50年，全球终生生产力增加25800亿美元，将是累积治疗费用5940亿美元的四倍，全球投资产生的净收益为16600亿美元：每投资1美元，净收益为3美元。总而言之，可以有效地减少过去严重被低估的儿童癌症负担，以实现巨大的健康和经济利益并避免数百万不必要的死亡。