Pediatric cancer mortality and survival in the United States, 2001‐2016

Abstract

Background Although pediatric cancer mortality and survival have improved in the United States over the past 40 years, differences exist by age, race/ethnicity, cancer site, and economic status. To assess progress, this study examined recent mortality and survival data for individuals younger than 20 years. Methods Age‐adjusted death rates were calculated with the National Vital Statistics System for 2002‐2016. Annual percent changes (APCs) and average annual percent changes (AAPCs) were calculated with joinpoint regression. Five‐year relative survival was calculated on the basis of National Program of Cancer Registries data for 2001‐2015. Death rates and survival were estimated overall and by sex, 5‐year age group, race/ethnicity, cancer type, and county‐based economic markers. Results Death rates decreased during 2002‐2016 (AAPC, –1.5), with steeper declines during 2002‐2009 (APC, –2.6), and then plateaued (APC, –0.4). Leukemia and brain cancer were the most common causes of death from pediatric cancer, and brain cancer surpassed leukemia in 2011. Death rates decreased for leukemia and lymphoma but were unchanged for brain, bone, and soft‐tissue cancers. From 2001‐2007 to 2008‐2015, survival improved from 82.0% to 85.1%. Survival was highest in both periods among females, those aged 15 to 19 years, non‐Hispanic Whites, and those in counties in the top 25% by economic status. Survival improved for leukemias, lymphomas, and brain cancers but plateaued for bone and soft‐tissue cancers. Conclusions Although overall death rates have decreased and survival has increased, differences persist by sex, age, race/ethnicity, cancer type, and economic status. Improvements in pediatric cancer outcomes may depend on improving therapies, access to care, and supportive and long‐term care.

Childhood cancer mortality trends in the Americas and Australasia: An update to 2017

“…However, some degree of misclassification is possible, as well as issues of random variation caused by a low number of deaths. Less favorable trends were registered for neoplasms of the CNS, particularly in Latin America 24 . In the United States, Canada, Japan, and Australia, death rates from neoplasms of the CNS were higher than those from leukemia, reflecting the lack of substantial improvements in the treatment of these malignancies, even in high‐income countries 24 .…”

“…Childhood cancer survival estimates vary broadly among countries worldwide. Globally, survival estimates showed a 70% gap between high‐ and low‐income countries, with the best 5‐year–net survival being over 80% in North America, comparable with several, but not all European countries 24,26,27 . In most of Latin America, pediatric cancer registers are still in the development stage, and for some countries reliable survival estimates are difficult to obtain 28 …”

“…Among these, the most favorable pattern emerged in Chile, and has been largely related to an efficient pediatric‐oncology care program implemented recently 30,37 . Survival in that country approximates that of the United States 24,37 . Despite the economic difficulties that Argentina has faced over the last 2 decades and the following cutbacks in public expenditures, recent mortality data are promising, although the absolute values remain comparably high 38 .…”

“…Less favorable trends were registered for neoplasms of the CNS, particularly in Latin America. 24 In the United States, Canada, Japan, and Australia, death rates from neoplasms of the CNS were higher than those from leukemia, reflecting the lack of substantial improvements in the treatment of these malignancies, even in high‐income countries. 24 In contrast, leukemia remained the main cause of childhood cancer deaths in Latin American countries—likely as a consequence of delays in diagnosis and lack of access to advanced treatments, as well as treatment discontinuation.…”

Geographical Distribution of Pediatric Cancer in Romania

“…To do this, the data are spatially modeled, geographic information systems can create sets of spatial models in an automated manner, allowing to do specific analysis. Geographic Information Systems are one of the tools used in implementing public policies capable of collecting, storing and processing a huge volume of statistical data with spatial reference [9], [10], [11], [12]. Medical data and the development of related GIS technologies make a significant contribution to research, minimize data processing time, help perform detailed analyzes, and spatially identify carcinogenic concentrations.…”