Key Takeaways
- In the United States, about 15,950 children and adolescents (ages 0-19 years) were diagnosed with cancer in 2022.
- Globally, childhood cancer incidence is estimated at 397,000 new cases annually for children aged 0-19 years as of 2020.
- In Europe, the annual incidence rate of pediatric cancer is approximately 35 per million children under 15 years.
- Leukemia represents 28% of all pediatric cancers in the U.S., most common type.
- Brain and CNS tumors account for 26% of childhood cancers in the U.S., second most common.
- Neuroblastoma comprises 6% of pediatric cancers, primarily affecting children under 5.
- 5-year survival for all pediatric cancers in U.S. is 85% for 2014-2020 diagnoses.
- Childhood ALL 5-year survival rate is 90-95% in high-income countries.
- Pediatric AML 5-year survival improved to 70% from 20% in 1970s.
- Pediatric cancer mortality in U.S. declined 60% since 1970, from 6.5 to 2.3 per 100,000.
- Globally, 96,000 children died from cancer in 2020, 90% in LMICs.
- Leukemia caused 25% of pediatric cancer deaths in U.S. 2016-2020.
- Genetic syndromes like Down syndrome increase leukemia risk 10-20 fold.
- Ionizing radiation exposure increases leukemia risk by 2x if prenatal.
- White children have highest incidence of ALL, 35 per million.
Despite affecting fewer people, pediatric cancer remains a leading cause of death for children worldwide.
Cancer Types and Distribution
- Leukemia represents 28% of all pediatric cancers in the U.S., most common type.
- Brain and CNS tumors account for 26% of childhood cancers in the U.S., second most common.
- Neuroblastoma comprises 6% of pediatric cancers, primarily affecting children under 5.
- Wilms tumor (nephroblastoma) makes up 5% of childhood cancers, 500-600 U.S. cases/year.
- Non-Hodgkin lymphoma is 3% of pediatric cancers, more common in adolescents.
- Hodgkin lymphoma accounts for 3% of childhood cancers, peak at 15-19 years.
- Retinoblastoma is 3% of cases, bilateral in 30%.
- Rhabdomyosarcoma represents 3% of pediatric malignancies, 350 U.S. cases/year.
- Bone cancers (osteosarcoma, Ewing) are 4-5% of childhood cancers.
- Germ cell tumors account for 3% of pediatric cancers, often gonadal.
- Liver cancers (hepatoblastoma) 1-2% of cases, mainly under 5 years.
- ALL is 75% of pediatric leukemias, peak age 2-5 years.
- AML is 20% of childhood leukemias, poorer prognosis.
- Medulloblastoma is 20% of pediatric brain tumors.
- Astrocytoma 15% of childhood CNS tumors.
- Ependymoma 5-10% of pediatric brain tumors.
- Thyroid cancer in adolescents is 10% of pediatric endocrine cancers.
- Melanoma is increasingly common in adolescents, 1-2% of pediatric cancers.
- Langerhans cell histiocytosis affects 1 in 200,000 children yearly, debated as cancer.
- Burkitt lymphoma is aggressive NHL subtype, 30-40% of pediatric NHL in Africa.
- Anaplastic large cell lymphoma 10-15% of pediatric NHL.
- Hepatoblastoma 60% of pediatric liver cancers, under 5 years.
- Pleuropulmonary blastoma rare, 25 cases/year worldwide.
- Desmoplastic small round cell tumor very rare, <200 cases total.
- Infantile fibrosarcoma 1% of pediatric sarcomas.
Cancer Types and Distribution Interpretation
Incidence and Prevalence
- In the United States, about 15,950 children and adolescents (ages 0-19 years) were diagnosed with cancer in 2022.
- Globally, childhood cancer incidence is estimated at 397,000 new cases annually for children aged 0-19 years as of 2020.
- In Europe, the annual incidence rate of pediatric cancer is approximately 35 per million children under 15 years.
- Among U.S. children aged 0-14 years, the age-adjusted incidence rate of all cancers combined was 17.9 per 100,000 from 2016-2020.
- Pediatric cancer accounts for less than 1% of all new cancer cases in the U.S., but represents 15-20% of cancer mortality in children.
- In low- and middle-income countries, 90% of the 400,000 annual childhood cancer cases occur, with incidence rates of 100-140 per million.
- The incidence of pediatric brain and other CNS cancers in the U.S. is 5.7 per 100,000 children aged 0-19.
- From 2001-2020, the overall pediatric cancer incidence rate in the U.S. increased by 0.5% per year on average.
- In Australia, around 600 children under 15 are diagnosed with cancer each year, rate of 16 per 100,000.
- Hispanic children in the U.S. have a 20% higher incidence rate of pediatric cancer compared to non-Hispanic whites.
- The incidence rate of leukemia in children aged 0-14 in the U.S. was 4.8 per 100,000 from 2016-2020.
- In the UK, there are about 1,900 new cases of childhood cancer diagnosed annually in children under 15.
- Pediatric cancer prevalence in the U.S. (5-year) is approximately 470,000 survivors alive as of 2022.
- In India, estimated 50,000 new pediatric cancer cases per year, with incidence rate around 40-50 per million.
- Black children in the U.S. have a pediatric cancer incidence rate of 15.5 per 100,000 vs. 17.2 for whites.
- The incidence of neuroblastoma in U.S. children under 5 years is 10.2 per million.
- In Canada, 1,050 children and teens are diagnosed with cancer yearly, rate 18.5 per 100,000.
- Global pediatric cancer incidence for ages 0-14 is 140 per million children per year.
- In Japan, pediatric cancer incidence rate is 12.5 per 100,000 for under 15 years.
- U.S. adolescents (15-19) have cancer incidence of 21.7 per 100,000, higher than younger children.
- In Brazil, around 8,500 new pediatric cancer cases annually for 0-19 years.
- Incidence of Wilms tumor in U.S. children 0-14 is 7.8 per million.
- In South Africa, pediatric cancer incidence is 100 per million, lower due to underdiagnosis.
- U.S. infant cancer incidence (under 1 year) is 23.4 per 100,000.
- In Germany, 1,800 children under 15 diagnosed yearly, rate 17 per 100,000.
- Global trend shows 1-3% annual increase in childhood cancer incidence since 1980.
- In France, pediatric cancer incidence rate is 16.5 per 100,000 under 15.
- Asian/Pacific Islander U.S. children have lowest pediatric cancer incidence at 13.4 per 100,000.
- In Mexico, 5,000 new cases yearly in children 0-18.
- Incidence of retinoblastoma worldwide is 3-4% of all childhood cancers, about 8,000 cases/year.
Incidence and Prevalence Interpretation
Mortality and Trends
- Pediatric cancer mortality in U.S. declined 60% since 1970, from 6.5 to 2.3 per 100,000.
- Globally, 96,000 children died from cancer in 2020, 90% in LMICs.
- Leukemia caused 25% of pediatric cancer deaths in U.S. 2016-2020.
- Brain tumors responsible for 27% of childhood cancer mortality.
- U.S. pediatric cancer death rate for ages 0-14 fell from 4.9 in 2001 to 2.2 per 100,000 in 2020.
- In 2022, estimated 1,650 cancer deaths in U.S. children 0-19 years.
- Mortality from neuroblastoma declined 3.7% annually 2001-2020.
- Wilms tumor mortality rate 0.4 per million children 0-14.
- Hodgkin lymphoma deaths rare, 0.2 per million.
- Bone cancer mortality 0.6 per 100,000 children.
- Global childhood cancer mortality expected to rise 86% by 2050 without intervention.
- In UK, 250 children die from cancer yearly.
- U.S. infant cancer mortality 3.3 per 100,000.
- AML mortality declined 2.1% per year 2011-2020.
- CNS tumor mortality highest in ages 1-4 years.
- In Africa, 80% of pediatric cancer patients die due to lack of treatment.
- Adolescent cancer mortality 2.5 per 100,000, higher than younger.
- Late mortality in survivors 10x higher than general population.
- Rhabdomyosarcoma mortality 1.2 per million.
- Retinoblastoma mortality low in HICs but 40% in Africa.
- Overall U.S. pediatric cancer mortality trends down 1.7% annually since 2000.
Mortality and Trends Interpretation
Risk Factors and Demographics
- Genetic syndromes like Down syndrome increase leukemia risk 10-20 fold.
- Ionizing radiation exposure increases leukemia risk by 2x if prenatal.
- White children have highest incidence of ALL, 35 per million.
- Boys have 15-20% higher risk of pediatric cancer overall.
- Maternal smoking during pregnancy increases neuroblastoma risk 1.5-2 fold.
- Hispanic ethnicity linked to 30% higher ALL risk.
- Beckwith-Wiedemann syndrome increases Wilms tumor risk 7-10%.
- Family history doubles retinoblastoma risk if heritable.
- Li-Fraumeni syndrome raises lifetime cancer risk to 90%.
- Twins have 2-3x higher concordance for leukemia.
- Pesticide exposure in utero increases leukemia risk 2-4 fold.
- Black children lower incidence but higher mortality for some cancers.
- Older maternal age (>40) linked to 2x Down syndrome leukemia risk.
- EBV infection risk for Burkitt lymphoma in endemic areas.
- Congenital anomalies increase cancer risk 2-3x.
- Immunosuppression post-transplant raises NHL risk 100x.
- Rural living associated with higher leukemia incidence.
- HIV increases pediatric cancer risk, esp. Kaposi sarcoma.
- Male predominance in bone sarcomas (1.5:1 ratio).
- Neonatal jaundice not linked, but low birthweight increases neuroblastoma 1.5x.
- No strong infectious cause, but delayed infections may protect against ALL.
Risk Factors and Demographics Interpretation
Survival Rates and Prognosis
- 5-year survival for all pediatric cancers in U.S. is 85% for 2014-2020 diagnoses.
- Childhood ALL 5-year survival rate is 90-95% in high-income countries.
- Pediatric AML 5-year survival improved to 70% from 20% in 1970s.
- Brain tumor 5-year survival in children is 74%, varies by type.
- Neuroblastoma stage 1: 99% 5-year survival; stage 4: 50%.
- Wilms tumor 5-year survival 90% overall, 100% for favorable histology stage I.
- Hodgkin lymphoma 5-year survival 95% in children.
- Non-Hodgkin lymphoma 5-year survival 85-90%.
- Osteosarcoma 5-year survival 70% for localized, 25% metastatic.
- Ewing sarcoma 5-year survival 70-80% localized.
- Retinoblastoma 5-year survival 99% in U.S., 60% in low-income countries.
- Rhabdomyosarcoma 5-year survival 65% overall.
- Medulloblastoma 5-year survival 70-80% with current therapy.
- Hepatoblastoma 5-year survival 70% localized, 40% metastatic.
- 10-year survival for childhood cancer survivors is 80-85%.
- ALL high-risk 5-year survival 80-85%, standard risk 98%.
- Diffuse intrinsic pontine glioma (DIPG) 5-year survival <1%.
- Adrenocortical carcinoma in children 5-year survival 55%.
- Bilateral retinoblastoma survival 95% with eye preservation in 50%.
- Infant ALL 5-year survival 50-60%, poorer than older children.
- Ependymoma 5-year survival 70-85% after total resection.
- Embryonal tumors 5-year survival 65% overall.
- 20-year survival for 1970s pediatric cancer cohort was 75%, now 90%.
- Black children have 20% lower 5-year survival for ALL compared to whites.
- In LMICs, overall pediatric cancer survival is 20-30% vs. 80% in HICs.
Survival Rates and Prognosis Interpretation
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