Childhood Cancer and Functional Impacts Across the Care Continuum (2021) / Chapter Skim
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Appendix B: Epidemiology and Attributes of Specific Childhood Cancers
Appendix B: Epidemiology and Attributes of Specific Childhood Cancers
Pages 439-494
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From page 439... ...
, 456 Medulloblastoma (intracranial and intraspinal embryonal tumors) , 459 SELECTED NON–CENTRAL NERVOUS SYSTEM SOLID TUMORS Ewing sarcoma (includes related sarcoma of bone)
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• Estimated numbers of cases diagnosed annually in the United States are based on the incidence rate applied to the 2010 U.S. census for individuals under the age of 18 living in the United States.
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. • Risk-based treatment approaches are used to determine treatment agents/modality/intensity.
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Age-Specific Annual Incidence by Race/Ethnicity Acute Lymphoid Leukemia 120 ALL 100 Annual Incidence per 106 White Black Hispanic 80 60 40 20 0 0-1 1-2 2-3 3-4 4-5 5-6 6-7 7-8 8-9 9-10 10-11 11-12 12-13 13-14 14-15 15-16 16-17 17-18 Age at Diagnosis (Years)
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APPENDIX B 443 Survival by Age at Diagnosis Acute Lymphoid Leukemia 1.00 0.90 0.80 Proportion Surviving 0.70 0.60 0.50 0.40 0.30 0-4 Years 5-9 Years 0.20 10-17 Years 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 Survival by Year of Diagnosis Acute Lymphoid Leukemia AL 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
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. • Prognosis can vary depending on demographic factors such as age at diagnosis, biologic features including white blood cell count at presentation, and genetic markers within the leukemia cells.
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Age-Specific Annual Incidence by Race/Ethnicity Acute Myeloid Leukemia 30.00 AML 25.00 Annual Incidence per 106 White Black Hispanic 20.00 15.00 10.00 5.00 0.00 0-1 1-2 2-3 3-4 4-5 5-6 6-7 7-8 8-9 9-10 10-11 11-12 12-13 13-14 14-15 15-16 16-17 17-18 Age at Diagnosis (Years)
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446 CHILDHOOD CANCER AND FUNCTIONAL IMPACTS Survival by Age at Diagnosis Acute Myeloid Leukemia 1.00 0.90 0.80 Proportion Surviving 0.70 0.60 0.50 0.40 0.30 0-4 Years 5-9 Years 0.20 10-17 Years 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 Survival by Year of Diagnosis Acute Myeloid Leukemia AML 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 AML
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• The very good survival rates for childhood Hodgkin lymphoma have driven therapeutic focus to minimizing long-term morbidity.
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Age-Specific Annual Incidence by Race/Ethnicity Hodgkin Lymphoma HL 40.00 35.00 Annual Incidence per 106 White Black Hispanic 30.00 25.00 20.00 15.00 10.00 5.00 0.00 0-1 1-2 2-3 3-4 4-5 5-6 6-7 7-8 8-9 9-10 10-11 11-12 12-13 13-14 14-15 15-16 16-17 17-18 Age at Diagnosis (Years)
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APPENDIX B 449 Survival by Age at Diagnosis Hodgkin Lymphoma 1.00 0.90 0.80 Proportion Surviving 0.70 0.60 0.50 0.40 0.30 0-4 Years 5-9 Years 0.20 10-17 Years 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 Survival by Year of Diagnosis Hodgkin Lymphoma 1.00 HL 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 HL
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The risk of late effects is associated with the treatment program. • Risk-determining factors include the pathologic subtype and stage (Murphy classification)
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Age-Specific Annual Incidence by Race/Ethnicity Non-Hodgkin Lymphoma 30.00 NHL 25.00 Annual Incidence per 106 White Black Hispanic 20.00 15.00 10.00 5.00 0.00 0-1 1-2 2-3 3-4 4-5 5-6 6-7 7-8 8-9 9-10 10-11 11-12 12-13 13-14 14-15 15-16 16-17 17-18 Age at Diagnosis (Years)
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452 CHILDHOOD CANCER AND FUNCTIONAL IMPACTS Survival by Age at Diagnosis Non-Hodgkin Lymphoma 1.00 0.90 0.80 Proportion Surviving 0.70 0.60 0.50 0.40 0.30 0-4 Years 5-9 Years 0.20 10-17 Years 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 Survival by Year of Diagnosis Non-Hodgkin Lymphoma NHL 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 NHL
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grade types and numerous subtypes defined by histologic, biologic, and genetic characteristics. • Low-grade astrocytomas are by far the most common type of astrocytoma and have a better prognosis and survival outcomes compared with high-grade astrocytomas, which have a very poor prognosis and overall survival.
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454 CHILDHOOD CANCER AND FUNCTIONAL IMPACTS Figures for Astrocytoma Age-Specific Annual Incidence Astrocytoma 30 25 Annual Incidence per 106 20 15 10 5 0 0-1 1-2 2-3 3-4 4-5 5-6 6-7 7-8 8-9 9-10 10-11 11-12 12-13 13-14 14-15 15-16 16-17 17-18 Age at Diagnosis (Years) Age-Specific Annual Incidence by Sex ASTRO Astrocytoma 30.00 25.00 Annual Incidence per 106 Male Female 20.00 15.00 10.00 5.00 .00 0-1 1-2 2-3 3-4 4-5 5-6 6-7 7-8 8-9 9-10 10-11 11-12 12-13 13-14 14-15 15-16 16-17 17-18 Age at Diagnosis (Years)
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APPENDIX B 455 Survival by Age at Diagnosis Astrocytoma 1.00 0.90 0.80 Proportion Surviving 0.70 0.60 0.50 0.40 0.30 0-4 Years 5-9 Years 0.20 10-17 Years 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 Survival by Year of Diagnosis Astrocytoma 1.00 ASTRO 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 ASTRO
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• Metastasis throughout the CNS occurs in fewer than 10 percent of cases and is associated with poor prognosis. • Risk categories include age, degree of surgical resection, and stage (local or metastatic disease)
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APPENDIX B 457 Figures for Ependymoma Age-Specific Annual Incidence Ependymoma 8 7 Annual Incidence per 106 6 5 4 3 2 1 0 0-1 1-2 2-3 3-4 4-5 5-6 6-7 7-8 8-9 9-10 10-11 11-12 12-13 13-14 14-15 15-16 16-17 17-18 Age at Diagnosis (Years) Age-Specific Annual Incidence by Sex Ependymoma 8.00 Epen d 7.00 Annual Incidence per 106 Male Female 6.00 5.00 4.00 3.00 2.00 1.00 .00 0-1 1-2 2-3 3-4 4-5 5-6 6-7 7-8 8-9 9-10 10-11 11-12 12-13 13-14 14-15 15-16 16-17 17-18 Age at Diagnosis (Years)
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458 CHILDHOOD CANCER AND FUNCTIONAL IMPACTS Survival by Age at Diagnosis Ependymoma 1.00 0.90 0.80 Proportion Surviving 0.70 0.60 0.50 0.40 0.30 0-4 Years 5-9 Years 0.20 10-17 Years 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 Survival by Year of Diagnosis Ependymoma Epen 1.00 d 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 Epen d
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• The molecular subtypes have different mechanisms of oncogenesis. Future clinical trials will increasingly rely on molecular targeted therapies, and protocols are predicted to evolve to allow introduc tion of targeted therapies while minimizing treatment with conven tional chemotherapy and radiation.
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460 CHILDHOOD CANCER AND FUNCTIONAL IMPACTS Figures for Medulloblastoma Age-Specific Annual Incidence Medulloblastoma 12 10 Annual Incidence per 106 8 6 4 2 0 0-1 1-2 2-3 3-4 4-5 5-6 6-7 7-8 8-9 9-10 10-11 11-12 12-13 13-14 14-15 15-16 16-17 17-18 Age-Specificat Diagnosis (Years) Age Annual Incidence by Sex Medulloblastoma 14.00 MED 12.00 Annual Incidence per 106 Male Female 10.00 8.00 6.00 4.00 2.00 .00 0-1 1-2 2-3 3-4 4-5 5-6 6-7 7-8 8-9 9-10 10-11 11-12 12-13 13-14 14-15 15-16 16-17 17-18 Age at Diagnosis (Years)
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APPENDIX B 461 Survival by Age at Diagnosis Medulloblastoma 1.00 0.90 0.80 Proportion Surviving 0.70 0.60 0.50 0.40 0.30 0-4 Years 5-9 Years 0.20 10-17 Years 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 Survival by Year of Diagnosis Medulloblastoma MED 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 MED
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This is detected using fluorescence in situ hybridization. • Prognosis varies depending on patient age and sex, tumor location and size, presence or absence of metastases, elevated serum lactate dehydrogenase, and a variety of biological factors.
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Age-Specific Annual Incidence by Race/Ethnicity Ewing Sarcoma 7.00 ES 6.00 Annual Incidence per 106 White Black Hispanic 5.00 4.00 3.00 2.00 1.00 0.00 0-1 1-2 2-3 3-4 4-5 5-6 6-7 7-8 8-9 9-10 10-11 11-12 12-13 13-14 14-15 15-16 16-17 17-18 Age at Diagnosis (Years)
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464 CHILDHOOD CANCER AND FUNCTIONAL IMPACTS Survival by Age at Diagnosis Ewing Sarcoma 1.00 0.90 0.80 Proportion Surviving 0.70 0.60 0.50 0.40 0.30 0-4 Years 5-9 Years 0.20 10-17 Years 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 Survival by Year of Diagnosis ES Ewing Sarcoma 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 ES
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As a group, GCTs are among the most curable tumors of childhood. • The most important features driving prognosis are the age of the patient, the cell types present, the height of plasma tumor marker elevation, the location of the tumor in the gonad (testis or ovary)
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Age-Specific Annual Incidence by Race/Ethnicity Germ Cell Tumors 35.00 GC 30.00 Annual Incidence per 106 White Black Hispanic 25.00 20.00 15.00 10.00 5.00 0.00 0-1 1-2 2-3 3-4 4-5 5-6 6-7 7-8 8-9 9-10 10-11 11-12 12-13 13-14 14-15 15-16 16-17 17-18 Age at Diagnosis (Years)
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APPENDIX B 467 Survival by Age at Diagnosis Germ Cell Tumors 1.00 0.90 0.80 Proportion Surviving 0.70 0.60 0.50 0.40 0.30 0-4 Years 5-9 Years 0.20 10-17 Years 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 Survival by Year of Diagnosis G Germ Cell Tumors 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 G
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. • Complete surgical resection by an expert team is the cornerstone for curative therapy.
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APPENDIX B 469 Figures for Hepatoblastoma Age-Specific Annual Incidence Hepatoblastoma 14 12 Annual Incidence per 106 10 8 6 4 2 0 0-1 1-2 2-3 3-4 4-5 5-6 6-7 7-8 8-9 9-10 10-11 11-12 12-13 13-14 14-15 15-16 16-17 17-18 Age at Diagnosis (Years) Age-Specific Annual Incidence by Sex Hep Hepatoblastoma 16.00 14.00 Annual Incidence per 106 Male Female 12.00 10.00 8.00 6.00 4.00 2.00 0.00 0-1 1-2 2-3 3-4 4-5 5-6 6-7 7-8 8-9 9-10 10-11 11-12 12-13 13-14 14-15 15-16 16-17 17-18 Age at Diagnosis (Years)
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0.10 * Insufficient number of cases 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 Survival by Year of Diagnosis Hepatoblastoma 1.00 Hep 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 Hep
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Patients with spitzoid melanoma and young patients with malignant melanoma often have positive sentinel node biopsies but remain at low risk for recurrence. Adolescents with malignant melanoma should be treated according to adult algorithms.
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Age-Specific Annual Incidence by Race/Ethnicity Malignant Melanoma 18.00 Mel 16.00 Annual Incidence per 106 14.00 White Black Hispanic 12.00 10.00 8.00 6.00 4.00 2.00 0.00 0-1 1-2 2-3 3-4 4-5 5-6 6-7 7-8 8-9 9-10 10-11 11-12 12-13 13-14 14-15 15-16 16-17 17-18 Age at Diagnosis (Years)
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APPENDIX B 473 Survival by Age at Diagnosis Malignant Melanoma 1.00 0.90 0.80 Proportion Surviving 0.70 0.60 0.50 0.40 0.30 0-4 Years 5-9 Years 0.20 10-17 Years 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 Survival by Year of Diagnosis Mel Malignant Melanoma 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 Mel
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Neuroblastoma can exhibit a broad spectrum of behavior, from spontaneous regression to aggressive disease requiring intensive multimodality treatment to achieving cure in only half of patients. • The most important features driving prognosis are age; stage; and certain biological features of the tumor, including unfavorable or favorable histology, the presence of MYCN amplification, the mean number of chromosomes (ploidy)
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APPENDIX B 475 Figures for Neuroblastoma Age-Specific Annual Incidence Neuroblastoma 60 50 Annual Incidence per 106 40 30 20 10 0 0-1 1-2 2-3 3-4 4-5 5-6 6-7 7-8 8-9 9-10 10-11 11-12 12-13 13-14 14-15 15-16 16-17 17-18 Age at Diagnosis (Years) Age-Specific Annual Incidence by Sex NBL Neuroblastoma 60.00 50.00 Annual Incidence per 106 Male Female 40.00 30.00 20.00 10.00 0.00 0-1 1-2 2-3 3-4 4-5 5-6 6-7 7-8 8-9 9-10 10-11 11-12 12-13 13-14 14-15 15-16 16-17 17-18 Age at Diagnosis (Years)
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476 CHILDHOOD CANCER AND FUNCTIONAL IMPACTS Survival by Age at Diagnosis Neuroblastoma 1.00 0.90 0.80 Proportion Surviving 0.70 0.60 0.50 0.40 0.30 0-4 Years 5-9 Years 0.20 10-17 Years 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 Survival by Year of Diagnosis NB Neuroblastoma 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 N
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They are more common in adolescents and adults than in younger children. • Types of NRSTS include synovial sarcoma, fibrosarcomas, periphBL eral nerve sheath tumors, desmoplastic small round cell tumor (DSRCT)
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478 CHILDHOOD CANCER AND FUNCTIONAL IMPACTS Figures for Non-Rhabdomyosarcoma Soft-Tissue Sarcomas
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Treatment for low-grade tumors consists of surgery alone. Treatment for intermediate- and high grade tumors consists of neoadjuvant chemotherapy, surgery, and adjuvant chemotherapy.
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APPENDIX B 481 Figures for Osteosarcoma Age-Specific Annual Incidence Osteosarcoma 14 12 Annual Incidence per 106 10 8 6 4 2 0 0-1 1-2 2-3 3-4 4-5 5-6 6-7 7-8 8-9 9-10 10-11 11-12 12-13 13-14 14-15 15-16 16-17 17-18 Age at Diagnosis (Years) Age-Specific Annual Incidence by Sex Osteosarcoma OS 16.00 14.00 Male Female Annual Incidence per 106 12.00 10.00 8.00 6.00 4.00 2.00 0.00 0-1 1-2 2-3 3-4 4-5 5-6 6-7 7-8 8-9 9-10 10-11 11-12 12-13 13-14 14-15 15-16 16-17 17-18 Age at Diagnosis (Years)
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482 CHILDHOOD CANCER AND FUNCTIONAL IMPACTS Survival by Age at Diagnosis Osteosarcoma 1.00 0.90 0.80 Proportion Surviving 0.70 0.60 0.50 0.40 0.30 0-4 Years 5-9 Years 0.20 10-17 Years 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 Survival by Year of Diagnosis OS Osteosarcoma 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 OS
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• Survivors of retinoblastoma are at high risk of developing subse quent neoplasms and also suffer from other late effects, including diminished orbital growth after enucleation, visual field defects, and chemotherapy-associated hearing loss.
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484 CHILDHOOD CANCER AND FUNCTIONAL IMPACTS Figures for Retinoblastoma Age-Specific Annual Incidence Retinoblastoma 35 30 Annual Incidence per 106 25 20 15 10 5 0 0-1 1-2 2-3 3-4 4-5 5-6 6-7 7-8 8-9 9-10 10-11 11-12 12-13 13-14 14-15 15-16 16-17 17-18 Age at Diagnosis (Years) Age-Specific Annual Incidence by Sex Retinoblastoma RB 35.00 30.00 Annual Incidence per 106 Male Female 25.00 20.00 15.00 10.00 5.00 0.00 0-1 1-2 2-3 3-4 4-5 5-6 6-7 7-8 8-9 9-10 10-11 11-12 12-13 13-14 14-15 15-16 16-17 17-18 Age at Diagnosis (Years)
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APPENDIX B 485 Survival by Age at Diagnosis Retinoblastoma 1.00 0.90 0.80 Proportion Surviving 0.70 0.60 0.50 0.40 0.30 0-4 Years 5-9 Years 0.20 10-17 Years 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 Survival by Year of Diagnosis RB Retinoblastoma 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 RB
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This will allow a more tailored approach to tumors based on expected response to therapy and help identify novel targeted therapies for patients with these genetic aberrations.
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APPENDIX B 487 Figures for Rhabdomyosarcoma Age-Specific Annual Incidence Rhabdomyosarcoma 10 9 8 Annual Incidence per 106 7 6 5 4 3 2 1 0 0-1 1-2 2-3 3-4 4-5 5-6 6-7 7-8 8-9 9-10 10-11 11-12 12-13 13-14 14-15 15-16 16-17 17-18 Age at Diagnosis (Years) Age-Specific Annual Incidence by Sex Rhabdomyosarcoma Rhab 12.00 d 10.00 Annual Incidence per 106 Male Female 8.00 6.00 4.00 2.00 0.00 0-1 1-2 2-3 3-4 4-5 5-6 6-7 7-8 8-9 9-10 10-11 11-12 12-13 13-14 14-15 15-16 16-17 17-18 Age at Diagnosis (Years)
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488 CHILDHOOD CANCER AND FUNCTIONAL IMPACTS Survival by Age at Diagnosis Rhabdomyosarcoma 1.00 0.90 0.80 Proportion Surviving 0.70 0.60 0.50 0.40 0.30 0-4 Years 5-9 Years 0.20 10-17 Years 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 Survival by Year of Diagnosis Rha Rhabdomyosarcoma d 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 Rha d
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ab d • Differentiated thyroid carcinomas (DTCs) account for the majority of thyroid carcinomas, followed by medullary thyroid carcinomas (10 percent)
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490 CHILDHOOD CANCER AND FUNCTIONAL IMPACTS Figures for Thyroid Carcinoma
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• A number of prognostic factors have been identified and are used to tailor treatment for Wilms tumor. • Very low-risk patients undergo surgery only while high-risk pa tients undergo surgery, multimodality chemotherapy, and radiation therapy.
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Age-Specific Annual Incidence by Race/Ethnicity Wilms Tumor 30.00 Wilm 25.00 Annual Incidence per 106 White Black Hispanic 20.00 15.00 10.00 5.00 0.00 0-1 1-2 2-3 3-4 4-5 5-6 6-7 7-8 8-9 9-10 10-11 11-12 12-13 13-14 14-15 15-16 16-17 17-18 Age at Diagnosis (Years)
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494 CHILDHOOD CANCER AND FUNCTIONAL IMPACTS Survival by Age at Diagnosis Wilms Tumor 1.00 0.90 0.80 Proportion Surviving 0.70 0.60 0.50 0.40 0.30 0-4 Years 5-9 Years 0.20 10-17 Years 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 Survival by Year of Diagnosis Wilms Tumor 1.00 Wil 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 Wil
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