Childhood Cancer and Functional Impacts Across the Care Continuum (2021) / Chapter Skim
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2 Epidemiology of Childhood Cancer in the United States
2 Epidemiology of Childhood Cancer in the United States
Pages 27-46
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From page 27... ...
Cancer therapy can potentially have adverse consequences. In this report and in the medical literature, the following terms are frequently used to denote the temporal occurrence of an event or condition representing the effect of cancer treatment on the health and function of the cancer patient: • Acute effect of cancer therapy: an event or condition that occurs during or immediately following cancer treatment.
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From page 28... ...
SEER Program typically reports cancer incidence according to age-specific groupings consisting of 5-year intervals. For the present report, the committee used SEER data for the period 1990–20161 to calculate overall and diagnosis-specific (based on the International Classification of Childhood Cancer [Steliarova-Foucher et al., 2017]
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. The SEER Program reports incidence rates by race, defined by the categories White, Black, Other (American Indian/Alaska Native, Asian/ Pacific Islander)
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Acute myeloid leukemia 8.1 0.05 I(c) Chronic myeloproliferative 1.0 0.01 diseases I(d)
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Neuroblastoma and other 9.5 0.05 peripheral nervous cell tumors IV(a) Neuroblastoma and 9.2 0.05 ganglioneuroblastoma IV(b)
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Extracranial and extragonadal 1.4 0.01 germ cell tumors X(c) Malignant gonadal germ cell 4.8 0.03 tumors X(d)
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FIGURES 2-1A–C Age-specific annual incidence rates per million population of cancer diagnosed among those aged 0–17 years in the United States overall (panel A) , by sex (panel B)
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Since the late 1960s and early 1970s, the survival rate among children diagnosed with cancer has steadily improved, and there has been a FIGURE 2-2 Temporal trend in the annual incidence rate of cancer (per 100,000 population) in the United States among those diagnosed at ages 0–15.
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From page 35... ...
Moreover, the classification and categorization of childhood cancers are continually evolving with the emergence of new knowledge relating to the molecular, pathologic, and prognostic characteristics of this diverse group of malignancies. Leukemias, lymphomas, and central nervous system cancers Survival by Year of Diagnosis 1.00 0.90 0.80 Proportion Surviving 0.70 0.60 0.50 0.40 0.30 1990-99 2000-09 0.20 2010-16 0.10 0.00 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Years from Diagnosis FIGURE 2-3 Survival for individuals diagnosed with cancer at ages 0–17 in the United States, by year of diagnosis.
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From page 36... ...
36 CHILDHOOD CANCER AND FUNCTIONAL IMPACTS TABLE 2-2 5- and 10-Year Survival by Year of Diagnosis for Individuals Diagnosed with Cancer at Ages 0–17 in the United States Year of Diagnosis Survival 1990– 2000– 2010– Diagnosis (ICCC) Time 1999 2009 2016 Lymphoid leukemias 5 yr 83.1% 89.3% 90.8% 10 yr 79.9% 86.5% Acute myeloid leukemia 5 yr 44.4% 62.5% 68.8% 10 yr 42.8% 60.1% Hodgkin lymphoma 5 yr 95.0% 96.2% 99.2% 10 yr 93.0% 95.1% Non-Hodgkin lymphomas 5 yr 80.2% 85.0% 91.0% 10 yr 79.1% 83.4% Ependymoma 5 yr 65.4% 78.0% 91.4% 10 yr 57.2% 69.9% Astrocytoma 5 yr 82.4% 85.5% 79.9% 10 yr 80.5% 83.6% Medulloblastoma 5 yr 61.9% 72.8% 67.6% 10 yr 57.5% 67.0% Neuroblastoma 5 yr 69.1% 76.4% 82.8% 10 yr 66.4% 73.5% Retinoblastoma 5 yr 96.8% 97.4% 93.0% 10 yr 96.4% 97.4% Wilms tumor 5 yr 91.4% 91.7% 96.4% 10 yr 89.7% 90.9% Hepatoblastoma 5 yr 62.6% 73.5% 87.9% 10 yr 62.6% 71.6% Osteosarcomas 5 yr 67.7% 71.8% 67.9% 10 yr 62.1% 65.9% Ewing tumor 5 yr 66.9% 75.9% 76.3% 10 yr 60.3% 69.8% Rhabdomyosarcomas 5 yr 69.1% 66.7% 74.1% 10 yr 67.7% 62.2% Non-rhabdomyosarcoma STS 5 yr 70.0% 75.7% 79.8% 10 yr 67.1% 71.7%
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From page 37... ...
In contrast to the impressive gains achieved in treatment, survival rates, and insights into the genetic/biologic characteristics of childhood cancers, progress in understanding the etiology of most cancers in this age group has been limited. Demographic characteristics are the etiologic risk factors most strongly and consistently associated with the incidence of specific
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From page 38... ...
GATA2, Fanconi anemia (FANCA, FANCC, ANKRD26, FANCG, BRCA2) ETV6, RUNX1 Other bone marrow failure syndromes Juvenile CBL syndrome myelomonocytic Noonan syndrome (PTPN11, KRAS, leukemia NRAS)
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From page 39... ...
* DNA repair disorders include conditions such as ataxia telangiectasia, Bloom syndrome, Fanconi anemia, dyskeratosis congenita, Nijmegen breakage syndrome, Rothmund-Thomson syndrome, Diamond-Blackfan syndrome, and Xeroderma pigmentosum.
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From page 40... ...
Numerous large case-control epidemiologic investigations, many conducted in North America and Europe during the 1980s and 1990s, included thousands of childhood cancers within the most common diagnoses and incorporated what was then state-of-the-art clinical and biological characterization of cases along with environmental sampling to enhance exposure assessment. These large-scale epidemiologic studies, employing primarily case-control designs, found a variety of associations for factors related to the preconception and pregnancy
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From page 41... ...
The cytotoxic agents and other modalities used to treat childhood cancers have been linked to risk for a variety of chronic health conditions that either develop early in the course of treatment and persist for the long term, or present as late effects many years after the completion of therapy. Cancer treatment–related toxicity is typically modality-specific and often dose-related, but additional factors related to the patient, the particular cancer, the health care system, and the cancer care provider influence an individual survivor's health outcomes (Dixon et al., 2018; Robison and Hudson, 2014)
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From page 42... ...
In so doing, findings from health outcomes research have provided a major impetus for change in pediatric cancer therapy and have informed health screening of survivors of childhood cancer. To demonstrate the magnitude of physical health conditions experienced by survivors, the cumulative burden methodology (Bhakta et al., 2017)
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2-9 Based on historical cohorts of survivors of childhood/adolescent cancers, the cumulative burden of multiple chronic health condi tions is substantially greater in this population than is observed in individuals without a history of cancer. 2-10 hronic and late effects of cancer treatment clearly predispose C survivors to greater and more severe morbidity and premature mortality compared with age- and sex-matched controls.
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2010. Ethnic differences in chronic health conditions after hematopoietic cell transplantation: A report from the Bone Marrow Transplant Survivor Study.
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2018. Temporal patterns in the risk of chronic health conditions in survivors of childhood cancer diagnosed 1970-99: A report from the Child hood Cancer Survivor Study cohort.
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From page 46... ...
2018. Changing geographical patterns and trends in cancer incidence in children and adolescents in Europe, 1991-2010 (Automated Childhood Cancer Information System)
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