Unidad Nacional de Oncologia Pediatrica, Guatemala City, Guatemala: A study of critical success factors contributing to the realization of a pediatric cancer program in Guatemala

Pediatric cancer represents less than two percent of the annual worldwide cancer burden. However, cancer is the leading cause of disease-related death in children between the ages of five and fourteen in resource-rich countries. Only 20--30% of children with cancer, mostly from high-income countries, are adequately diagnosed and treated. Children with cancer from low and middle income countries (LMIC) represent the larger cohort of patients and simultaneously have the least probability of surviving cancer. The World Health Organization's 2014 World Cancer Report authored by the International Agency for Research on Cancer reported that approximately 90,000 of children's annual deaths worldwide are attributed to cancer. The majority of these childhood deaths occur in LMIC. Five-year survival rates for childhood cancer in developed countries approaches 80%. However, childhood cancer survival rates in resource-poor countries are dismal. Current estimates report five-year childhood cancer survival rates that range from 5--30% in developing countries, with the upper tier of the reported survival rates predominately occurring in upper economic level of the LMICs. It is in these LMICs where there are opportunities for developing more comprehensive and sustainable childhood cancer programs.;This study provides an opportunity to examine critical success factors (CSF) that contribute to the development of sustainable pediatric cancer programs in LMIC settings. The Unidad Nacional de Oncologia Pediatrica (UNOP) in Guatemala was been selected as a representative pediatric cancer program in an LMIC setting. The study results will be correlated to the experiences at the UNOP. This study utilized a survey methodology that incorporated both quantitative and qualitative research methods to examine CSFs attributed to successful and sustainable pediatric cancer programs in LMIC settings. The research identified the top five CSFs that are essential for the realization of a pediatric cancer programs in LMICs and their relevance to the cancer program in Guatemala.