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Childhood Cancer:Incidence, Survival and Mortality
Pediatric Resident
Education Series
Childhood Cancer
Purpose is to describe the incidence and survival of various types of cancer in kids and how these parameters are affected by:
Age Race / Ethnicity Gender
Childhood Cancer
General Statistics: Approximately 12,400 new diagnoses/year < 20 yo
0-14 = 8,700 15-19 = 3,700
Thus, incidence is 150 per million children < 20 yo newly diagnosed with cancer each year, or 1/ 7,000
The probability of a newborn developing cancer by age 20 is between 0.3 – 0.32%, or ~ 1/300
1,500-1,600 deaths/year in children < 15 years of age
Overall Trends
Incidence relatively stable
Mortality declining
Age Specific Incidence Rates forChildhood Cancers
Age Specific Incidence Rates forChildhood Cancers
Incidence rate similar for youngest (< 5 yr) and oldest (15-19 yr) age groups
But… histologies (or types of cancer) are different in these groups
Incidence distribution by histologychildren < 5 yrs vs. > 15 yrs
Age Specific Incidence Rates forChildhood Cancers
Age Specific Incidence Rates forChildhood Cancers Most common cancer
< 15 yrs – leukemia > 15 yrs – lymphoma
Second most common < 10 yrs – CNS tumors 10-14 yrs – lymphoma > 15 yrs – leukemia
Distribution of Specific Cancer Diagnoses for Children and Adolescents
Incidence of Cancers is Influenced by Race/Ethnicity – US data 1990-95
In adults, incidence of cancer more common in blacks than whites
For children, cancer was less common in
blacks than whites Incidence for Hispanic &
Asian/Pacific islanders intermediate between blacks and whites
American Indians had the lowest incidence of any group
Incidence of Cancers is Influenced by Race/Ethnicity
Incidence of cancer influenced by gender
Generally higher in males than females
Some histologies show gender predisposition
Age may also influence sex distribution
e.g.Hodgkins
Age < 15 yrs
male > female
Age > 15 yrs
female > male
Trend in Survival Rates for Childhood Cancer – overall & specific
Trend in Survival Rates for Specific Childhood Cancers
Leading Causes of Death in Children < 14 y/o in the USA
1997
Leading Causes of Death in Adolescents in the USA
1997
The converse of survival...
Overall Mortality rate decreasing
Distribution by Cause of Cancer Death
Overall distribution of incidence by cancer type
LeukemiaCNSLymphomaNeuroblastomaWilmsBoneRetinoblastomaLiverSarcomaOther
Mortality Rates for Childhood Cancers
Age-specific cancer mortality…
Related to incidence and type of cancer in the age groups
Age-specific cancer mortality…
Age-specific cancer mortality…
Summary
Cancers of children represent a diverse group of diagnoses with a distinctive age-incidence pattern
The incidence of cancer among children has remained essentially stable over several decades
The mortality rates for all cancer types have decreased dramatically over the last several decades
Credits
Information and tables, for the most part, taken from the SEER monograph on Childhood Cancer Cancer Incidence and Survival Among Children and
Adolescents: United States SEER Program 1975-1995 http://seer.cancer.gov/publications/childhood/
Other tables taken from Gurney JG & Bondy ML, “Epidemiology of Childhood Cancer”, in Principles and Practice of Pediatric Oncology, 5th ed, Pizzo PA and Poplack DA, eds, LWW, 2005. http://www.lww.com/static/docs/product/samplechapter
s/0-7817-5492-5_Chapter%201.pdf
Michael Kelly MD PhDAnne Warwick MD MPH