title: Cancer incidence rates and trends among children and adolescents in the United States, 2001-2009.
abstract: OBJECTIVE
  Cancer continues to be the leading disease-related cause of death among children and adolescents in the United States. More current information is needed to describe recent cancer trends and identify demographic and geographic variations.
  
  
  METHODS
  We analyzed data from the National Program of Cancer Registries and Surveillance, Epidemiology, and End Results statewide registries representing 94.2% of the US population to identify cancers diagnosed among persons aged 0 to 19 years during 2001-2009. Age-adjusted rates and annual percentage change for trends were calculated. Data were stratified by age, gender, race, ethnicity, and geography.
  
  
  RESULTS
  We identified 120,137 childhood and adolescent cancer cases during 2001-2009 with an age-adjusted incidence rate of 171.01 per million. The overall rate of all cancers combined remained stable over time (annual percent change [APC], 0.3%; 95% confidence interval [CI], -0.1 to 0.7). There was an increase in the overall cancer trend among African American children and adolescents (APC, 1.3%; 95% CI, 0.2 to 2.5). An increasing trend for thyroid cancer was observed among both genders (APC, 4.9%; 95% CI, 3.2 to 6.6) and specifically among adolescents and those in the Northeast, South, and West regions of the United States. Renal carcinoma incidence was increasing significantly overall (APC, 5.4%; 95% CI, 2.8 to 8.1). Extracranial and extragonadal germ cell tumors and melanoma were both significantly decreasing.
  
  
  CONCLUSIONS
  This study reports the novel finding that renal carcinoma rates are increasing among children and adolescents. This study confirms that thyroid cancer rates are increasing and further describes rising cancer rates among African Americans.
authors.affiliation: Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia; and.
authors.forename: David A
authors.initials: DA
authors.lastname: Siegel
authors.affiliation: Cancer Surveillance Branch.
authors.forename: Jessica
authors.initials: J
authors.lastname: King
authors.affiliation: Comprehensive Cancer Control Branch.
authors.forename: Eric
authors.initials: E
authors.lastname: Tai
authors.affiliation: Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, and.
authors.forename: Natasha
authors.initials: N
authors.lastname: Buchanan
authors.affiliation: Offices of Surveillance, Epidemiology, and Laboratory Services (OSELS), Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Umed A
authors.initials: UA
authors.lastname: Ajani
authors.affiliation: Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, and ffa2@cdc.gov.
authors.forename: Jun
authors.initials: J
authors.lastname: Li
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000208:ethnology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009369:Neoplasms / Q000175:diagnosis* / Q000208:ethnology*; D011159:Population Surveillance / Q000379:methods*; D012042:Registries; D018426:SEER Program / Q000639:trends*; D014481:United States / Q000208:ethnology; D055815:Young Adult
keywords: adolescent; cancer; children; incidence; pediatric