Outcomes for children and adolescents with cancer: challenges for the twenty-first century.
OBJECTIVE
This report provides an overview of current childhood cancer statistics to facilitate analysis of the impact of past research discoveries on outcome and provide essential information for prioritizing future research directions.


METHODS
Incidence and survival data for childhood cancers came from the Surveillance, Epidemiology, and End Results 9 (SEER 9) registries, and mortality data were based on deaths in the United States that were reported by states to the Centers for Disease Control and Prevention by underlying cause.


RESULTS
Childhood cancer incidence rates increased significantly from 1975 through 2006, with increasing rates for acute lymphoblastic leukemia being most notable. Childhood cancer mortality rates declined by more than 50% between 1975 and 2006. For leukemias and lymphomas, significantly decreasing mortality rates were observed throughout the 32-year period, though the rate of decline slowed somewhat after 1998. For remaining childhood cancers, significantly decreasing mortality rates were observed from 1975 to 1996, with stable rates from 1996 through 2006. Increased survival rates were observed for all categories of childhood cancers studied, with the extent and temporal pace of the increases varying by diagnosis.


CONCLUSIONS
When 1975 age-specific death rates for children are used as a baseline, approximately 38,000 childhood malignant cancer deaths were averted in the United States from 1975 through 2006 as a result of more effective treatments identified and applied during this period. Continued success in reducing childhood cancer mortality will require new treatment paradigms building on an increased understanding of the molecular processes that promote growth and survival of specific childhood cancers.
Smith
Malcolm A
MA
Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, MD 20892, USA. Malcolm.Smith@NIH.GOV
Seibel
Nita L
NL
Altekruse
Sean F
SF
Ries
Lynn A G
LA
Melbert
Danielle L
DL
O'Leary
Maura
M
Smith
Franklin O
FO
Reaman
Gregory H
GH
D000293:Adolescent; D002648:Child; D005544:Forecasting; D006801:Humans; D015994:Incidence; D009369:Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D018426:SEER Program; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
J Clin Oncol. 2000 Aug;18(16):3004-11
10944134
Blood. 2002 Dec 15;100(13):4298-302
12393590
Blood. 2003 May 15;101(10):3809-17
12531809
N Engl J Med. 2005 Mar 10;352(10):978-86
15758008
Br J Haematol. 2005 Jul;130(2):166-73
16029445
Proc Natl Acad Sci U S A. 2009 Jun 9;106(23):9414-8
19470474
Pediatr Blood Cancer. 2005 Jan;44(1):13-20
15534881
Leukemia. 2008 Jan;22(1):189-93
17690702
Br J Haematol. 2008 Jun;141(6):840-7
18371107
Med Pediatr Oncol. 1997 Dec;29(6):526-33
9324339
Biol Blood Marrow Transplant. 2008 Feb;14(2):137-80
18215777
Blood. 2004 Jun 15;103(12):4396-407
14551133
J Clin Oncol. 2004 Jul 15;22(14):2873-6
15254055
Int J Cancer. 2008 Apr 15;122(8):1859-67
18076067
J Clin Oncol. 2006 May 20;24(15):2352-8
16710034
Blood. 1994 Jul 15;84(2):570-3
8025282
Stat Med. 2000 Feb 15;19(3):335-51
10649300
Cancer Epidemiol Biomarkers Prev. 2005 Aug;14(8):1928-34
16103439
N Engl J Med. 2003 Feb 20;348(8):694-701
12594313
Blood. 2006 Jul 15;108(2):441-51
16556894
N Engl J Med. 1998 Jun 4;338(23):1663-71
9614257
Pediatr Blood Cancer. 2008 Jun;50(6):1169-75
18293379
Cancer. 2005 Apr 1;103(7):1457-67
15712273
Cancer. 1976 Aug;38(2):633-46
184912
J Clin Oncol. 1998 Dec;16(12):3744-51
9850017
Blood. 2008 Mar 1;111(5):2548-55
18039957
J Clin Oncol. 2009 Mar 1;27(7):1007-13
19171716
Cancer. 1989 Jul 15;64(2):349-60
2544249
Blood. 2008 Sep 1;112(5):1646-54
18502832
Cancer. 1981 May 1;47(9):2302-11
6164480
Br J Haematol. 2008 Oct;143(2):261-7
18759768
J Clin Oncol. 1986 Dec;4(12):1732-9
3491184
J Natl Cancer Inst. 1998 Sep 2;90(17):1269-77
9731733
Int J Cancer. 2009 Jun 1;124(11):2658-70
19173295
Leukemia. 2000 Dec;14(12):2205-22
11187912
Lancet. 2007 Jun 23;369(9579):2106-20
17586306
J Clin Oncol. 1993 Jun;11(6):1024-32
8501488
Blood. 2007 Apr 1;109(7):2773-80
17132719
N Engl J Med. 1999 Oct 14;341(16):1165-73
10519894
Pediatr Blood Cancer. 2007 Dec;49(7):928-40
17066459
Eur J Cancer. 2006 Sep;42(13):1961-71
16919764
J Clin Oncol. 2003 May 15;21(10):2011-8
12743156
Blood. 2001 Jun 1;97(11):3370-9
11369626
J Natl Cancer Inst. 2008 Sep 17;100(18):1301-9
18780868
Cancer. 2004 Sep 1;101(5):1072-80
15329918
N Engl J Med. 2009 Jan 29;360(5):470-80
19129520
N Engl J Med. 1986 Jun 19;314(25):1600-6
3520317
Blood. 2007 Apr 1;109(7):2736-43
17138821
J Clin Oncol. 1998 Jan;16(1):237-45
9440748
BMJ. 2005 Jun 4;330(7503):1294
15849205
Ann Intern Med. 1977 Sep;87(3):293-8
71004
J Clin Oncol. 2009 Mar 1;27(7):1034-40
19171711
J Clin Oncol. 2006 Sep 1;24(25):4202-8
16943538
J Clin Oncol. 2008 May 10;26(14):2384-9
18467730
J Clin Oncol. 2009 Nov 1;27(31):5175-81
19805687
Pediatr Blood Cancer. 2007 Dec;49(7):894-900
17584910
N Engl J Med. 1983 Mar 10;308(10):559-65
6338381