Mexico Implements Protocols for Childhood Cancer

The Ministry of Health of Mexico, through the General Health Council, has declared childhood cancer a health priority by developing four National Medical Care Protocols (PRONAM). These documents aim to improve timely diagnosis, early intervention, and the quality of care for girls, boys, and adolescents across the country. The protocols seek to reduce gaps in access to specialized services, strengthen the capabilities of health personnel—especially at the first level of care—and unify clinical criteria within the National Health System, regardless of the patient's affiliated institution. The four developed protocols in pediatric oncology address priority entities due to their frequency, impact, and potential for cure when detected early: Early diagnosis of cancer in girls, boys, and adolescents; Acute lymphoblastic leukemia in girls, boys, and adolescents; Retinoblastoma; Hodgkin's lymphoma in girls, boys, and adolescents. Each protocol integrates clear clinical criteria, diagnostic algorithms, and referral pathways with the goal of shortening the time between clinical suspicion and the start of specialized treatment. The Secretary of Health, David Kershenobich, has emphasized that PRONAM directly strengthen the first level of care, where the most important opportunity to identify early signs and symptoms of childhood cancer is concentrated. 'Timely access to health services makes a fundamental difference. A girl or boy with leukemia who receives care in the initial stages can achieve up to an 80 percent chance of a cure,' he noted. In the secretary's view, National Medical Care Protocols are essential when it comes to the clinical impact of early detection. 'From an institutional perspective, the implementation of PRONAM contributes to the construction of a Universal Health Service, in which all public institutions provide homogeneous care, based on scientific evidence, without distinction for affiliation or labor union. This approach seeks to avoid unjustified variations in clinical practice, improve the continuity of care, and ensure that medical decisions are based on updated national guidelines,' he added. The Secretary of the General Health Council, Patricia Clark, has emphasized that the PRONAM for Early diagnosis of cancer in girls, boys, and adolescents is specifically designed for first-level care personnel. This protocol includes infographics, clinical algorithms, and QR codes that facilitate the recognition of warning signs, the indication of initial studies, and the timely referral criteria to specialized services. In contrast, the protocols for acute lymphoblastic leukemia, Hodgkin's lymphoma, and retinoblastoma are oriented towards specialized care and incorporate risk factors, therapeutic schemes, and clinical follow-up routes. According to Patricia Clark, to date, 10 National Medical Care Protocols have been published, all developed with the participation of specialists and researchers, which guarantees technical rigor, clinical relevance, and alignment with the real needs of the health system institutions. PRONAM are characterized by being concise documents, supported by the best available scientific evidence, and aimed at facilitating their application in daily clinical practice. The protocols can be openly consulted at: https://pronamsalud.csg.gob.mx/