New epidemiological data have raised concerns over a significant increase in childhood and adolescent cancer cases in Cyprus over the past decade, with experts warning that the country lacks the data needed to explain the trend.
According to Cyprus's 2025 Cancer Country Profile, prepared by the Organisation for Economic Co-operation and Development (OECD) and the European Commission, an estimated 22 children aged up to 14 were diagnosed with cancer in 2022.
The estimated incidence rate stood at 15 cases per 100,000 children, compared with the European Union average of 13.7 per 100,000, placing Cyprus around 10% above the EU average. The figures are estimates based on available registry data and previous trends rather than final confirmed case numbers for 2022.
Leukaemia was the most common form of childhood cancer, accounting for around 36% of cases, followed by brain and central nervous system tumours (27%) and lymphomas (19%).
The report also estimated childhood cancer mortality in Cyprus at 2.3 deaths per 100,000 children, slightly above the EU average of 2.1 per 100,000.
Long-standing pattern
The elevated incidence of childhood and adolescent cancer in Cyprus is not a new finding.
The first nationwide population-based study using the Cyprus Childhood Cancer Registry, covering the period from 1998 to 2017, ranked Cyprus among the countries with the highest incidence rates internationally.
Across all cancer types, the age-standardised incidence for children and adolescents up to the age of 19 was estimated at 203.5 cases per million population. Among the countries included in the comparison, only Italy and Belgium recorded higher rates.
The study found no statistically significant overall increase in childhood and adolescent cancers over the period. However, it did identify a marked rise in thyroid cancer, particularly among girls and adolescents aged 15 to 19, with Cyprus recording one of the highest incidence rates worldwide.
Experts call for improved monitoring
Professor Constantinos Makris, Professor of Environmental Health and Director of the Cyprus International Institute for Environmental and Public Health at the Cyprus University of Technology (CUT), said recent figures published by the International Agency for Research on Cancer (IARC), part of the World Health Organization, indicate a notable increase in new childhood cancer cases in Cyprus over the past decade.
However, he said current evidence does not allow researchers to determine why the increase appears to be greater than in many other European countries.
"The question of why new cases are increasing disproportionately in Cyprus compared with other European countries cannot currently be answered with precision," he said.
Makris attributed this largely to the absence of a comprehensive system for collecting long-term data on children's environmental, behavioural and metabolic exposures.
He said Cyprus does not currently operate a surveillance system capable of monitoring either established or emerging cancer risk factors over time.
Among the factors that should be monitored, he said, are obesity, poor diet, smoking exposure, air pollution and exposure to chemicals such as pesticides. However, he stressed that there is no evidence at present linking the increase in Cyprus to any single factor, adding that multiple exposures or as-yet unidentified causes may be involved.
Focus on children's lifetime exposures
Makris said particular attention should be given to critical stages of development, including conception, pregnancy and early childhood.
He argued that research should focus on what scientists describe as the "exposome" — the totality of non-genetic environmental, lifestyle and social exposures experienced throughout a person's life.
"Genes cannot change significantly within ten years," he said, noting that improvements in diagnostic techniques may explain part of the increase in recorded cases but are unlikely to account for the entire trend.
He called for the establishment of a national system to collect prospective data on children's daily environment, diet, lifestyle, social conditions and environmental exposures.
"By studying children's exposome in greater detail, we will be better able to understand the multifactorial nature of childhood cancer and explore why some children develop the disease while others do not," he said.
