Tehran University of Medical Sciences Basic & Clinical Cancer Research 2228-6527 17 1 2026 06 13 241 251 Azadeh Angouraj Taghavi Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran Kazem Zendehdel Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran Hamideh Rashidian Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran 2025 12 16 2026 01 23 Pediatric cancers are a leading cause of death from non‑communicable diseases among children worldwide, with considerable regional variation in age‑standardized incidence and mortality rates. This study reviews the epidemiology of pediatric cancers in Iran in the context of global patterns, highlighting disparities in incidence, mortality, and survival outcomes. Incidence and mortality data were compared using the Iranian national cancer registry and GLOBOCAN 2020, while survival data were contrasted between the Iranian national study (IRANCANSURV) and the international CONCORD‑3 project. Globally, childhood cancer incidence ranges from 157 per million in very high‑income countries to 85 per million in low‑income regions. Iran reports an age-standardized incidence rate of 136 per million—one of the highest in the Eastern Mediterranean Region.The leading cancer types are leukemia (21 per million mortality) and brain/CNS tumors (15 per million). In Iran, the five‑year survival rate is approximately 68–70% for leukemia and 49% for CNS tumors, substantially below the > 90% and > 70% observed in high‑income settings. Survival also varies markedly across provinces—from 56.9% to 71.5% for leukemia and 16% to 57% for CNS cancers—reflecting disparities in healthcare access and data quality. Overall, although Iran exhibits relatively high childhood cancer incidence, outcomes remain limited by disparities in healthcare infrastructure, resource constraints, and incomplete registry coverage. These findings underscore substantial gaps in surveillance and emphasize the urgent need to strengthen pediatric oncology services, expand equitable access to specialized care, and enhance data collection to inform evidence‑based policy decisions. https://bccr.tums.ac.ir/index.php/bccrj/article/view/594