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. 2014 Aug 15;120(16):2497-506.
doi: 10.1002/cncr.28748. Epub 2014 May 22.

Declining childhood and adolescent cancer mortality

Malcolm A Smith  1 , Sean F Altekruse, Peter C Adamson, Gregory H Reaman, Nita L Seibel
Affiliations

Declining childhood and adolescent cancer mortality

Malcolm A Smith et al. Cancer. .

Abstract

Background: To evaluate whether progress continues in identifying more effective treatments for children and adolescents with cancer, the authors examined both overall and disease-specific childhood cancer mortality rates for the United States, focusing on data from 2000 to 2010.

Methods: Age-adjusted US mortality trends from 1975 to 2010 were estimated using joinpoint regression analysis. Analyses of annual percentage change (APC) were performed on the same diagnostic groupings for the period restricted to 2000 through 2010 for groupings ages <20 years, <15 years, and 15 to 19 years.

Results: After a plateau in mortality rates during 1998 to 2002 (APC, 0.3%), the annual decline in childhood cancer mortality from 2002 to 2010 (APC, -2.4%) was similar to that observed from 1975 to 1998 (APC, -2.7%). Statistically significant declines in mortality rates from 2000 to 2010 were noted for acute lymphoblastic leukemia, acute myeloid leukemia, non-Hodgkin lymphoma, Hodgkin lymphoma, neuroblastoma, central nervous system cancers, and gonadal cancers. From 2000 to 2010, the rates of decline in mortality for the group ages 15 to 19 years generally were equal to or greater than the rates of decline for the group ages birth to 14 years. Improvements in treatment since 1975 resulted >45,000 cancer deaths averted through 2010.

Conclusions: Cancer mortality for both children and adolescents declined from 2000 to 2010, with significant declines observed for multiple cancer types. However, greater than 1900 cancer deaths still occur each year among children and adolescents in the United States, and many survivors experience long-term effects that limit their quality of life. Continued research directed toward identifying more effective treatments that produce fewer long-term sequelae is critical to address these remaining challenges.

Keywords: adolescents; childhood cancer; childhood leukemia; childhood solid tumors; mortality rates.

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Conflict of interest statement

The authors have no financial disclosures to declare.

Figures

Figure 1
Figure 1
Patterns of mortality for children and adolescents < 15 years and 15–19 years for 2007–2010. ALL = acute lymphoblastic leukemia, AML = acute myeloid leukemia, Oth Leuk = other leukemia, NHL = non-Hodgkin lymphoma.
Figure 2
Figure 2
Age-adjusted mortality trends for all malignant cancers among children younger than 20 years of age in the United States from 1975 through 2010 with annual percentage change (APC) by joinpoint segments and estimated averted deaths per year. “*” indicate that the slope of the joinpoint segment is statistically different from zero, P<0.05.
Figure 3
Figure 3
Age-adjusted mortality trends for all malignant cancers among children younger than 20 years of age in the United States from 1975 through 2010, with annual percentage changes (APCs) for joinpoint segments. “*” indicate that the slope of the joinpoint segment is statistically different from zero, P<0.05. Green line is for leukemias and lymphomas, and blue line is for all other cancer sites.
Figure 4
Figure 4
Five-year relative survival, all malignant cancers combined, children 0–4, 5–14 and 15–19 years of age at diagnosis in SEER 9 registries during four year time periods from 1975–1978 to 2003–2007 with follow-up through 2010.
Figure 5
Figure 5
Five-year relative survival, hematopoietic cancers among children <15 and 15–19 years of age at diagnosis in SEER 9 registries, 1975–1978 to 2003–2007 with follow-up through 2010: (A) Acute lymphoblastic leukemia; (B) Acute myeloid leukemia; (C) Non-Hodgkin lymphoma; and (D) Hodgkin lymphoma
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