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BABCKGROUND: There is insufficient research into the state of paediatric oncology in African countries. OBJECTIVES: The purpose of this study was to analyse the state of paediatric oncology between 1995 and 2004 in Cote d'lvoire. METHODS: This retrospective descriptive study analysed all patients under the age of 18 who were diagnosed with cancer in Cote d'lvoire over a period of 10 years (January 1995 - December 2004) with regard to demographics, types of pathology, delay in diagnosis and treatment, treatment modalities, abandonment of treatment and survival rate. RESULTS: Of 405 patients diagnosed with cancer, 331 were included in the study. Burkitt's lymphoma was the most common malignancy (73.6%), followed by nephroblastoma (14.5%) and acute leukaemia (4%). Delay in diagnosis occurred in 38.7% of cases and ranged from 1 to 3 months; the average delay from diagnosis to starting treatment was 18 days. An abdominal mass and swelling of the jaw were the most common clinical presentations. Almost half of the patients (48.6%) were lost to follow-up and over a third (39.3%) died shortly after admission owing to advanced disease. The overall survival rate was 9.4%. CONCLUSIONS: Cancer in children in Cote d'lvoire was dominated by Burkitt's lymphoma. The rate of loss to follow-up of almost 50% is grounds for concern. The overall survival rate of 9.4% is very low, but such figures are not uncommon for African countries. Collaboration within the Franco-African Group of Paediatric Oncology has contributed to improving the management of children with cancer.