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Epidemiology of Childhood Cancer: Incidence, Survival and Mortality

Epidemiology of 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.

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Epidemiology of Childhood Cancer: Incidence, Survival and Mortality

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  1. Epidemiology of Childhood Cancer:Incidence, Survival and Mortality Pediatric Resident Education Series

  2. 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

  3. 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

  4. Overall Trends • Incidence relatively stable • Mortality declining

  5. Age Specific Incidence Rates for Childhood Cancers

  6. 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

  7. Incidence distribution by histologychildren < 5 yrs vs. > 15 yrs

  8. Age Specific Incidence Rates forChildhood Cancers

  9. 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

  10. Distribution of Specific Cancer Diagnoses for Children and Adolescents

  11. 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

  12. Incidence of Cancers is Influenced by Race/Ethnicity

  13. 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

  14. Trend in Survival Rates for Childhood Cancer – overall & specific

  15. Trend in Survival Rates for Specific Childhood Cancers

  16. Leading Causes of Death in Children < 14 y/o in the USA 1997

  17. Leading Causes of Death in Adolescents in the USA 1997

  18. The converse of survival... • Overall Mortality rate decreasing

  19. Distribution by Cause of Cancer Death Overall distribution of incidence by cancer type

  20. Mortality Rates for Childhood Cancers

  21. Age-specific cancer mortality… • Related to incidence and type of cancer in the age groups

  22. Age-specific cancer mortality…

  23. Age-specific cancer mortality…

  24. 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

  25. 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/samplechapters/0-7817-5492-5_Chapter%201.pdf • Michael Kelly MD PhDAnne Warwick MD MPH

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