[Epidemiology of paediatric cancers in French-speaking Africa. The GFAOP hospital register].

In Francophone Africa (343 million inhabitants in 2024, 42% under 15 years of age), childhood cancer is under-documented. The French African Paediatric Oncology Group (GFAOP) launched a centralized hospital registry project (RFAOP) in 2016 to improve knowledge, structure the needs of paediatric oncology units, and address the lack of reliable information. Here, we describe this unique Registry, explaining what has been learned and its impact. Analyses of the Registry (2016-2019) reveal diagnostic disparities and a lack of correlation between the number of cases and the population, highlighting significant needs in human and material resources and underscoring the necessity for targeted investments. The Registry tracks cancer trends, and documents prevalent types of cancer, such as Burkitt's lymphoma in some regions, and very low numbers of brain tumours especially in the sub-Saharan region. The stage and extent of the disease at diagnosis is also discussed. Inter-unit heterogeneities and a hospital registry bias are noted. The application of staging guidelines has improved data quality, but late diagnoses persist with high percentages of advanced stage disease. Follow-up of survival 57% at 12 months is discussed, but encouraging rates are observed for certain cancers. Treatment abandonment is a major problem being studied using socio-economic and cancer type as possible contributing factors. This Registry is crucial for resource planning despite limitations in diagnosis and follow-up. On-going training and support are essential to maintain the quality of this project. It reveals disparities with global data, emphasizing the need for robust population-based registries linked to quality diagnostics and care, and for sustainable funding to ensure a lasting impact.