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. 2014 Oct;134(4):e945-55.
doi: 10.1542/peds.2013-3926. Epub 2014 Sep 8.

Cancer incidence rates and trends among children and adolescents in the United States, 2001-2009

David A Siegel  1 , Jessica King  2 , Eric Tai  3 , Natasha Buchanan  4 , Umed A Ajani  5 , Jun Li  6
Affiliations

Cancer incidence rates and trends among children and adolescents in the United States, 2001-2009

David A Siegel et al. Pediatrics. 2014 Oct.

Abstract

Objectives: 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.

Keywords: adolescent; cancer; children; incidence; pediatric.

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Figures

FIGURE 1
FIGURE 1
Cancer incidence rates per million in the United States, 2001–2009. Age-adjusted incidence of pediatric cancers stratified by age group. Rates are per million and were age-adjusted to the 2000 US standard population (19 age groups, Census P25–1130) standard. Data are from population-based cancer registries that participate in the NPCR or the SEER program. Data include malignant tumors only and cover 94.2% of the US population. The ICCC-3 is displayed by abbreviated title.
FIGURE 2
FIGURE 2
Cancer rates and APC in children and adolescents (ages 0–19 years) in the United States, 2001–2009. A, Overall rates and APC by race. B, Overall thyroid carcinoma rates and APC. C, Overall rates and APC of unspecified intracranial and intraspinal neoplasms, renal carcinomas, and extracranial and extragonadal germ cell tumors. Rates are per million and were age-adjusted to the 2000 US standard population (19 age groups, Census P25–1130) standard. Data are from population-based cancer registries that participate in the NPCR or the SEER program. Data include malignant tumors only and cover 94.2% of the US population. *Denotes significant APC. APCs were calculated by using weighted least squares method. Statistical significance was determined if the 95% CI of APC did not include zero (P < .05).
FIGURE 3
FIGURE 3
Significant APC of cancer rates in children and adolescents (ages 0–19 years) by ICCC-3 code displayed by US Census region, 2001–2009. Data are from population-based cancer registries that participate in the NPCR or the SEER program. Data include malignant tumors only and cover 94.2% of the US population. APCs were calculated by using weighted least squares method. Statistical significance was determined if the 95% CI of APC did not include zero (P < .05). APCs are expressed with 95% CIs. Some significant values appear to include zero because APC was rounded to the nearest 10th.
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