Cancer in children can occur anywhere in the body, including the blood and lymph node, brain, spinal cord, kidney and other organs and tissue, Cancer begins when healthy cell change and grow out of control. In most type of cancer, these cells form a mass called a tumour. A tumour can be cancerous or benign. A cancerous tumour is malignant, meaning it can grow and spread to other part of the body. Tumors that occurs in children are as diverse as those in adult and present a number of challenges for pathologist [1].

Compared with cancers that occur in adult, childhood cancers are rare comprising only1% of all the cancers [2]. More than 10% of all death in children below 15-years of age are caused by malignant diseases in the developed countries. In the developing world, cancers are yet to be recognized as a major pediatric illness, however they are fast emerging as a distinct entity to be dealt upon [3].

Cancer is leading cause of death for children and adolescents around the world and approximately 300,000 children aged 0-15 years old are diagnosed with cancer each year [4]. Childhood malignancy being a significant cause of death among children. The aim of the study is to find out the spectrum of childhood (<14 years) cancers in patients who presented to Jawaharlal Nehru Cancer hospital, Bhopal, M.P. for period of four years (2015- 2018).

Setting: This study was done in tertiary care Cancer hospital, Bhopal. M.P.

Duration: In this study four years data was collected from January 2015 to December 2018.

Type study: A cancer hospital based retrospective study.

Inclusion criteria: All children with cancer, aged 1-14 years diagnosed by mean of histological and cytological examination during four years period in JNCH (Jawaharlal Nehru Cancer Hospital), Bhopal were included in the study.

Exclusion criteria: All suspected cases but not confirmed pathologically.

Scoring system: The present study have followed ICCC (International childhood cancer classification) to classify the tumours.

In the present study, it was found that the male were affected more than females a ratio of 2.66:1 (Table 3)

Table-3: Sex wise distribution of cases.

Male / female ratio 2.66

It was observed that haematological malignancies were more common 172 (62.54%) than the non-haematological malignancies 103 (37.45%). Leukemia 150 (54.54%) is most common pediatric cancer amongst which Acute lymphoblastic leukemia is most common haematological malignancy. It accounts for 122 (44.36%) of total malignancies and 71% of total haematological malignancies. Amongst haematological malignancies ALL is followed by AML 23(8.36%), Non-Hodgkins Lymphoma 17 (6.18%) and Hodgkin`s Lymphoma 6 (2.18%) CML 5 (1.81%). Most common Non haematological malignancy is Sarcoma 20 (7.27%) and Brain tumours 20 (7.27%) followed by Osteosarcoma 8 (2.90%) Neuroblastoma 8 (2.90%), Retinoblastoma 8 (2.90%) Wilm`s tumours 6 (2.18%)

Table-4: Distribution of childhood cancer according to type and age (years).

Apart from being retrospective study this study has the limitation this current study is a single institution based study restricted by a small sample size and hence this retrospective review cannot serve as a benchmark for reference, Hence further multi institutional studies over a longer duration of time needs to be done to serve as a benchmark for future.

Although the exact incidence rate cannot be provided by this single institution-based study, the information is useful in showing distribution pattern of childhood malignancy in this region. It is not possible to prevent cancer in children. The most effective way to reduce the incidence of cancer is to focus on a early and correct diagnosis followed by effective therapy. Programmes to promote early and correct diagnosis have been successfully used in countries of all income level, often through collaborative effort of government, civil society and non-government organization with vital roles played by parent group.

This study is a single institution-based study done in Jawahar Lal Nehru cancer hospital, Bhopal. This is oldest cancer hospital in this region and patients comes from all over the Madhya Pradesh, Chhattisgarh and adjoining areas, hence from the study, a representation of spectrum of various malignancies in this part of India was generated.

Dr. Vidhi Gupta: Data collection, data analysis, literature search, drafted initial manuscript and approved the final manuscript before submission.

Dr. Ashish Kalraiya: Conceptualized the study, develop the study design, did literature search, data analysis, revised the manuscript and approved the final manuscript before submission.

Dr. Dinesh Mekle: Data analysis, literature search, revised the manuscript and approved the final manuscript before submission.