Childhood Cancers (American Cancer Society: Cancer Facts & Figures 2006-2013)

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2006-2013 – Childhood Cancer (Ages 0-14 years)
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Estimated new cases expected to occur
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2013 – 11,630
2012 – 12,060
2011 – 11,210
2010 – 10,700
2009 – 10,730
2008 – 10,730
2007 – 10,400
2006 – 9,500
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Estimated cancer deaths expected to occur
——————————————————————
about 1/3rd from leukemia
——————————————————————
2013 – 1,310
2012 – 1,340
2011 – 1,320
2010 – 1,340
2009 – 1,380
2008 – 1,490
2007 – 1,545
2006 – 1,560
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Major categories of pediatric cancer and more specific symptoms include:
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According to International Classification of Childhood Cancer, childhood cancers include: (2008-2010)
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• Leukemia (31% of all childhood cancers, including benign brain tumors) 2013
• Leukemia (34% of all childhood cancers) 2011-2012
• Leukemia (31.0% of all childhood cancers) 2010
• Leukemia (32.7% of all childhood cancers) 2009
• Leukemia (32.6% of all childhood cancers) 2008
• Leukemia (30% of all childhood cancers) 2007
• Leukemia (30%) 2006
may be recognized by:
bone and joint pain
weakness
pale skin
bleeding or bruising
fever or infection

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• Brain and other central nervous system tumors (25%) 2013
• Brain and other nervous system (27%) 2012
• Brain and other nervous system (27%) in early stages (2011)
(21.3%), which in early stages (2010)
• Brain and other nervous system (20.7%) in early stages (2009)
• Brain and other nervous system (21.1%) in early stages (2008)
• Brain and other nervous system (22.3%) in early stages (2007)
• Brain and other nervous system (22.3%) in early stages (2006)
may cause:
headaches
nausea
vomiting
blurred or double vision
dizziness
difficulty walking or handling objects

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• Neuroblastoma (6%) 2013
• Neuroblastoma (7%) 2012
• Neuroblastoma (7%) 2011
cancer of sympathetic nervous system
• Neuroblastoma (7.1%) (2010)
• Neuroblastoma (6.9%) (2009)
• Neuroblastoma (6.7%) (2008)
cancer of the sympathetic nervous system, can appear anywhere
• Neuroblastoma (7.3%) (2007)
• Neuroblastoma (7.3%) (2006)
cancer of nervous system
most common in children younger than 5 years of age

usually appears as swelling in abdomen
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• Wilms tumor (5%) 2013
• Wilms tumor (5%) 2012
• Wilms tumor (5%) 2011
• Wilms tumor (5.2%) 2010
• Wilms tumor (4.8%) 2009
• Wilms tumor (4.9%) 2008
• Wilms tumor (5.6%) 2006-2007
kidney cancer
may be recognized by swelling or lump in abdomen
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• Non-Hodgkin lymphoma (4%) and Hodgkin lymphoma (4%) 2013
• Non-Hodgkin lymphoma (4%) and Hodgkin lymphoma (4%) 2011-2012
• Non-Hodgkin lymphoma (4.3%) and Hodgkin lymphoma (3.8%) 2010
• Non-Hodgkin lymphoma (4.3%) and Hodgkin lym- phoma (3.6%) 2009
• Non-Hodgkin lymphoma (4.2%) and Hodgkin lymphoma (3.7%) 2008
• Non-Hodgkin lymphoma (4.5%) and Hodgkin lymphoma (3.5%) 2007
• Hodgkin lymphoma (3.5%) and non-Hodgkin lymphoma (4.5%) 2006
affect lymph nodes
may involve:
bone marrow and other organs (2013)
may spread to bone marrow and other organs (2006-2012)
may cause swelling of lymph nodes in:
neck
armpit
groin
as well as weakness and fever

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• Rhabdomyosarcoma (3%) 2011-2013
• Rhabdomyosarcoma (3.3%) 2010
• Rhabdomyosarcoma (3.5%) 2008-2009
• Rhabdomyosarcoma (3.1%) 2006-2007
soft tissue sarcoma
can occur in:
head and neck
genitourinary area
trunk
extremities
may cause pain and/or mass or swelling

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• Osteosarcoma (3%) 2011-2013
• Osteosarcoma (2.5%) 2010
• Osteosarcoma (2.7%) 2008-2009
• Osteosarcoma (2.4%) 2006-2007
bone cancer
most often occurs in adolescents commonly appears as sporadic pain in affected bone that may worsen at night or with activity, with eventual progression to local swelling
often has no initial pain or symptoms until local swelling begins (2006-2009)
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• Retinoblastoma (2%) 2013
• Retinoblastoma (3%) 2011-2012
• Retinoblastoma (2.6%) 2010
• Retinoblastoma (2.7%) 2009
• Retinoblastoma (2.8%) 2006-2008
eye cancer
usually occurs in children younger than 5 years of age
usually occurs in children younger than 4 years (2006-2010)
typically recognized because of discoloration behind pupil (2013)
typically recognized because of discoloration of eye pupil (2010-2012)
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• Ewing sarcoma (1%) 2011-2013
• Ewing sarcoma (1.6%) 2010
• Ewing sarcoma (1.4%) 2006-2009
type of cancer
usually arises in bone

most common in adolescents
typically appears as pain at tumor site
most often occurs in adolescents (2009-2011)
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Signs of childhood cancer include:
Symptoms of childhood cancer include: (2010-2011)
unusual mass or swelling
unexplained paleness or loss of energy
sudden increase in tendency to bruise or bleed
sudden tendency to bruise

(2006-2011)
persistent, localized pain
prolonged, unexplained fever or illness
frequent headaches, often with vomiting
sudden eye or vision changes
excessive, rapid weight loss

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2005-2009 – 0.6% per year
2004 to 2008 – 5% per year consistent trend since 1975
Overall, childhood cancer incidence rates have been increasing slightly 0.6% per year since 1975
Overall, childhood cancer incidence rates increased slightly
most recent 5 years of available data
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cancer is 2nd leading cause of death in children, exceeded only by accidents
——————————————————————
Childhood cancers are rare, representing less than 1% of all new cancer diagnoses
——————————————————————
2009 – 2.1 (per 100,000)
2008 – 2.2 (per 100,000)
1969 – 6.5 (per 100,000)
Mortality rates from childhood cancer have declined
2013 – 68% – over past 4 decades
2012 – 66% – over past 4 decades
2011 – 55% since 1975
2010 – 53% since 1975
2009 – 50% since 1975
2008 – since 1975 – almost 50%
2007 – 48% since 1975
2006 – since 1975 – about 48% –
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5-year survival among children (0-14 years of age) For most recent time period
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Rates vary considerably, depending on cancer type
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(1995- 2001) – 79% – for all sites combined
——————————————————————
(2002-2008) – 98% – retinoblastoma
——————————————————————
(2002-2008) – 96% – Hodgkin lymphoma
(2001-2007) – 95% – Hodgkin lymphoma
(1999­-2006) – 95% – Hodgkin lymphoma
(1999-2005) – 94% – Hodgkin lymphoma
(1996-2004) – 96% – Hodgkin lymphoma
(1996-2003) – 95% – Hodgkin lymphoma
(1996-2002) – 95% – Hodgkin lymphoma
(1995- 2001) – 95% – Hodgkin lymphoma
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(2002-2008) – 89% – Wilms tumor
(2001-2007) – 88% – Wilms tumor
(1999­-2006) – 89% – Wilms tumor
(1999-2005) – 88% – Wilms tumor
(1996-2004) – 92% – Wilms tumor
(1996-2003) – 92% – Wilms tumor
(1996-2002) – 92% – Wilms tumor
(1995- 2001) – 92% – Wilms tumor
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(2002-2008) – 86% – non-Hodgkin lymphoma
(2001-2007) – 86% – non-Hodgkin lymphoma
(1999­-2006) – 85% – non­Hodgkin lymphoma
(1999-2005) – 85% – non-Hodgkin lymphoma
(1996-2004) – 86% – non-Hodgkin lymphoma
(1996-2003) – 87% – non-Hodgkin lymphoma
(1996-2002) – 86% – non-Hodgkin lymphoma
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(2002-2008) – 84% – leukemia
(2001-2007) – 83% – leukemia
(1999­-2006) – 82% – leukemia
(1999-2005) – 82% – leukemia
(1996-2004) – 82% – leukemia
(1996-2003) – 81% – leukemia
(1996-2002) – 81% – leukemia
(1995- 2001) – 80% – leukemia
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(2002-2008) – 75% – neuroblastoma
(2001-2007) – 74% – neuroblastoma
(1999­-2006) – 73% – neuroblastoma
(1999-2005) – 74% – neuroblastoma
(1996-2004) – 70% – neuroblastoma
(1996-2003) – 69% – neuroblastoma
(1996-2002) – 69% – neuroblastoma
(1995- 2001) – 66% – neuroblastoma
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(2002-2008) – 75% – Ewing tumors
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(1996-2004) – 71% – bone and joint
(1996-2003) – 72% – bone and joint
(1996-2002) – 72% – bone and joint
(1995- 2001) – 71% – bone and joint
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(2002-2008) – 71% – brain and other central nervous system tumors
(2001-2007) – 71% – brain and other nervous system tumors
(1999­-2006) – 71% – brain and other nervous system
(1999-2005) – 71% – brain and other nervous system
(1996-2004) – 74% – brain and other nervous system
(1996-2003) – 74% – brain and other nervous system
(1996-2002) – 74% – brain and other nervous system
(1995- 2001) – 73% – brain and other nervous system
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(2002-2008) – 71% – osteosarcoma
(2001-2007) – 70% – osteosarcoma
(1999­-2006) – 70% – osteosarcoma
(1999-2005) – 69% – osteosarcoma
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(2002-2008) – 68% – rhabdomyosarcoma
(2001-2007) – 68% – rhabdomyosarcoma
(1999­-2006) – 66% – rhabdomyosarcoma
(1999-2005) – 66% – rhabdomyosarcoma
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Trends in 5-year Relative Survival Rates* (%) by Race, US, 1975-2008 (2013)
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Trends in 5-year Relative Survival Rates* (%) by Race, US, 1975-2007 (2012)
——————————————————————
Trends in 5-year Relative Survival Rates* (%) by Race and Year of Diagnosis, US, 1975-2006 (2011)
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Trends in 5-year Relative Survival Rates* (%) by Race and Year of Diagnosis, US, 1975-2005 (2010)
——————————————————————
Trends in 5-year Relative Survival Rates* (%) by Race and Year of Diagnosis, US, 1975-2004 (2009)
——————————————————————
Trends in 5-Year Relative Survival Rates* (%) by Race and Year of Diagnosis, US, 1975-2003 (2008)
——————————————————————
Trends in 5-Year Relative Survival* Rates (%) by Race and Year of Diagnosis, US, 1975-2002 (2007)
——————————————————————
Trends in 5-Year Relative Survival Rates* (%) by Race and Year of Diagnosis, US, 1974-2001 (2006)
——————————————————————
Brain & other nervous system
Brain (2006-2012)
——————————————————————
All races
——————————————————————
2002-2008 – 35% (2013)
2001-2007 – 35% (2013)
1999-2006 – 36% (2012)
1999-2005 – 36% (2010)
1996-2004 – 35% (2009)
1996-2003 – 35% (2008)
1996-2002 – 34% (2007)
1995-2001 – 33% (2006)
1987-1989 – 29% (2013)
1984-1986 – 29% (2012)
1984-1986 – 29% (2010)
1984-1986 – 29% (2009)
1984-1986 – 29% (2008)
1984-1986 – 29% (2007)
1983-1985 – 27% (2006)
1975-1977 – 24% (2012)
1975-1977 – 24% (2010)
1975-1977 – 24% (2009)
1975-1977 – 24% (2008)
1975-1977 -24% (2007)
1975-1977 – 22% (2013)
1974-1976 – 22% (2006)
——————————————————————
White
——————————————————————
2002-2008 – 34% (2013)
2001-2007 – 34% (2013)
1999-2006 – 35% (2012)
1999-2005 – 35% (2010)
1996-2004 – 34% (2009)
1996-2003 – 34% (2008)
1996-2002 – 34% (2007)
1995-2001 – 33% (2006)
1987-1989 – 28% (2013)
1984-1986 – 28% (2012)
1984-1986 – 28% (2010)
1984-1986 – 28% (2009)
1984-1986 – 28% (2008)
1984-1986 – 28% (2007)
1983-1985 – 26% (2006)
1975-1977 – 23% (2012)
1975-1977 – 23% (2010)
1975-1977 – 23% (2009)
1975-1977 – 23% (2008)
1975-1977 – 23% (2007)
1975-1977 – 22% (2013)
1974-1976 – 22% (2006)
——————————————————————
African American
——————————————————————
2002-2008 – 41% (2013)
2001-2007 – 40% (2013)
1999-2006 – 41% (2012)
1999-2005 – 41% (2010)
1996-2004 – 39% (2009)
1996-2003 – 37% (2008)
1996-2002 – 37% (2007)
1995-2001 – 38% (2006)
1987-1989 – 32%
1987-1989 – 31%
1984-1986 – 33% (2009)
1984-1986 – 33% (2008)
1984-1986 – 32% (2012)
1984-1986 – 32% (2010)
1984-1986 – 32% (2007)
1983-1985 – 32% (2006)
1975-1977 – 27% (2012)
1975-1977 – 27% (2010)
1975-1977 – 27% (2009)
1975-1977 – 27% (2008)
1975-1977 – 26% (2007)
1974-1976 – 26% (2006)
1975-1977 – 25% (2013)
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For all childhood cancers combined, 5-year relative survival rate has improved markedly over past 30 years due to new and improved treatments
——————————————————————
5-year relative survival rate increased for diagnoses
——————————————————————
Relative 5-Year Survival Rate (%)
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(2002-2008) – 83% in most recent time period
today – 83% (2012)
today – 80% (2011)
today – 80% (2010)
today – 80% (2009)
today – 80% (2008)
today – nearly 80% (2007)
in late 1990s – nearly 80% (2006)
mid-1970s – 58%
1970s – less than 50% before
due to new and improved treatments (2011)
1970s – less than 50% before (2010)
before 1970s – less than 50% (2006-2009)
rates vary considerably depending on
cancer type
patient age
other characteristics

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Survival for all invasive childhood cancers combined has improved markedly over the past 30 years due to new and improved treatments
——————————————————————
rates vary considerably depending on:
cancer type
patient age
other characteristics

patient characteristics (2011)
moreover, within major categories, cancer subtypes may vary in response to treatment and/or survival characteristics (2010)
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substantial progress in reducing childhood cancer mortality largely attributable to improvements in treatment and high rates of participation in clinical trials

substantial progress in childhood cancer largely attributable to improvements in treatment and high propor­tion of pediatric patients participating in clinical trials (2012)

substantial progress in childhood cancer survival rates largely attributable to improvements in treatment and high proportion of patients participating in clinical trials (2011)

substantial progress in pediatric cancer survival rates is attributable largely to improved treatments and high proportion of patients participating in clinical trials (2008-2009)
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Childhood cancers can be treated by combination of therapies
surgery
radiation
chemotherapy
chosen based on type and stage of cancer
(2006-2012)
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Treatment is coordinated by team of experts, including: (2006-2012)
pediatric oncologists
pediatric nurses
social workers
psychologists
and others who assist chil­ dren and their families

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If child is eligible, placement in a clinical trial, which compares new treatment to best current treatment, should also be considered (2011-2012)

If child is eligible, placement in clinical trial, which compares best current treatment to new treatment, should also be considered (2010)

If patient is eligible, placement in clinical trial should also be considered (2008-2009)
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Because these cancers are uncommon, outcomes are more successful when treatment is managed by children’s cancer center (2008-2012)
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Early symptoms usually nonspecific
——————————————————————
Parents should ensure children have regular medical check-ups and be alert to any unusual, persistent symptoms

Parents should ensure children have regular medical checkups and be alert to any unusual symptoms that persist (2006-2012)
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Pediatric cancer patients may experience treatment-related side effects long after active treatment (2013)

Pediatric cancer patients may experience treatment-related side effects not only during treatment, but many years after diagnosis as well (2012)

Pediatric cancer patients may experience treatment ­related side effects not only at time of treatment, but several years after diagnosis as well (2011)

Survivors of childhood cancer may experience treatment-related side effects (2006-2010)
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Late treatment effects include:
impairment in function of specific organs
organ malfunction (2006-2010)
secondary cancers
cognitive deficits (2013)
cognitive impairments (2006-2012)
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The Children’s Oncology Group (COG) has developed long-term follow-up guidelines for screening and management of late effects in survivors of childhood cancer
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For more information on childhood cancer management
http://www.survivorshipguidelines.org
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The Childhood Cancer Survivor Study, has followed more than 14,000 long-term childhood cancer survivors, provided important and valuable information about late effects of cancer treatment
ccss.stjude.org
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(Proportions are provided for all races combined and may vary according to race/ethnicity.) 2010-2012
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REFERENCES:
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2013:
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http://cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-036845.pdf
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2012:
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http://cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-031941.pdf
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2011:
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http://cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-029771.pdf
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2010:
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http://cancer.org/acs/groups/content/@nho/documents/document/acspc-024113.pdf
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2009:
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http://cancer.org/acs/groups/content/@nho/documents/document/500809webpdf.pdf
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2008:
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http://www.oralcancerfoundation.org/facts/pdf/worldcancer.pdf
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2007:
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http://cancer.org/acs/groups/content/@nho/documents/document/caff2007pwsecuredpdf.pdf
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2006:
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http://cancer.org/acs/groups/content/@nho/documents/document/caff2006pwsecuredpdf.pdf
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