More children are getting cancer in the United States: 0.5% more diagnoses each year

Childhood cancer is increasingly common in the United States. Between 2003 and 2019, the incident increased by half a percent each year, according to a study by the Centers for Disease Control (CDC, the equivalent of our RIVM) recently published in the Journal of the National Cancer Institute.

The researchers collected data from the USCS database, which covers more than 99% of the U.S. population, to assess age-adjusted incidence rates and trends in children and adolescents under the age of 19 year olds who were diagnosed with cancer during this time.

The results showed an overall cancer incidence of 178.3 per 1 million, with 248,749 cases reported during the period. Among the cancers with the highest incidence were leukemia (46.6), neoplasms of the central nervous system (30.8) and lymphoma (27.3). Among patients, researchers observed the highest rates in men, children up to age 4, non-Hispanic white children and adolescents, and those who lived in the Northeast, the wealthiest 25% of counties. by economic status and metropolitan counties with at least 1 million inhabitants.

The researchers looked at pediatric ages from zero to 19 years old. They studied the period from 2003 to 2019 and looked at a few metrics: the numbers, i.e. the number of cases; rate, which is the number of cases per 1 million people; and trends, which gauge whether the cancer is shrinking, growing, or staying the same. It took into account a few different variables, such as gender, age, race and ethnicity, geographic area, and type of cancer.

Significant increases

Researchers say childhood cancer is still a rare occurrence, but there are significant increases in a number of types, such as leukemia, lymphoma, liver tumors, bone tumors and thyroid cancer. Brain tumors showed an interesting trend: rates increased until 2017 and then decreased.

David A. Siegel, MD, MPH, pediatric hematologist/oncologist and commandant of the United States Health Service Commissioned Corps, led the study. “There are many different reasons why trends in cancer incidence may go up or down,” he says. “One of the factors is the change in coding. That’s how cancers are reported in these registries and that makes a difference. For example, the use of electronic pathology reports has increased over the past few decades. This facilitates the transmission of information from the pathologist to the cancer registries. There may also be changes in diagnostic patterns, such as how often doctors use MRIs to diagnose cancer. All this could affect certain trends.

He continues: “Risk factors can also change. For melanoma, for example, it is likely that some of the public health interventions aimed at reducing UV exposure have contributed to lower rates. On the other hand, we have seen an increase in hepatoblastoma, a form of liver cancer, in several studies. Some of the risk factors for this cancer may have changed and contributed to the increase.

Furthermore, Siegel points out that childhood cancer survival rates are increasing and mortality rates are decreasing. “So it is likely that we will have more cancer survivors, which is important because cancer survivors need long-term care. It is important for physicians to keep this in mind when considering these questions in the future. These data provide context for the design of clinical trials that will improve treatment outcomes and continue to improve survival for years to come.

Reference

David A Siegel, MD, MPH and others, Number, incidence rates and trends of childhood cancer in the United States, 2003-2019, JNCI: Journal of the National Cancer Institute2023;, djad115, https://doi.org/10.1093/jnci/djad115