VIGICANCER: Understanding Real-World Childhood Cancer Clinical Outcomes in Colombia to Inform Cancer Control Policy

Monitoring clinical outcomes is essential for cancer control. Yet, population-based surveillance systems are scarce in low- and middle-income countries (LMICs). To fill a real-world population-based data gap on cancer outcomes in Colombia, we implemented VIGICANCER in 2009, a nationwide childhood cancer clinical outcomes surveillance system to collect, analyze, and disseminate valid, reliable, and timely population-based information. This Special Article describes the evolution and impact of VIGICANCER, contextualized within the Latin-American population-based data systems landscape. VIGICANCER registers children (<19 years) newly diagnosed with cancer, receiving treatment at 27 participating institutions in 10 Colombian cities. VIGICANCER collects sociodemographic and clinical information, conducting quarterly active follow-up surveillance to document deaths, relapses, second malignancies, treatment abandonment, and loss to follow-up. To date, VIGICANCER has collected comprehensive data from >12,000 patients, covering 55%-60% of the projected new childhood cancer cases nationwide yearly. We describe clinical characteristics, 5-year overall survival (OS), and event-free survival (EFS) in a 14-year cohort of Colombian children with cancer. Kaplan-Meier and log-rank tests were used for survival analyses. From 2009 to 2023, VIGICANCER analyzed 9,986 patients and 3,626 events, including 3,081 deaths. The cohort's median age was 8.6 years (IQR, 4.0-13.7), 55.0% of patients (n = 5,489/9,986) were male, 8.0% (n = 757/9,479) were Black, 3.3% (n = 206/6,165) were Indigenous, and 49.9% (n = 4,849/9,711) had public insurance. Five-year OS and EFS were 63.3% (SE, 0.6) and 57.9% (SE, 0.6), respectively. VIGICANCER yields meaningful and actionable population-based data on the local standard of care, guiding data-driven multilevel interventions to improve survival. VIGICANCER provides a reproducible, equity-focused model for LMIC, demonstrating how real-world data inform cancer control policy to reduce survival disparities and advance the goals of the WHO Global Initiative for Childhood Cancer.