All statistics are for U.S. children from birth through age 19 unless stated otherwise. This summary relies on the most recent published data with respect to its contents, some of which dates back one or more years.
Diagnosis
In 2024, approximately 9,620 children ages 0-14 and 5,290 adolescents (15-19) will be diagnosed with cancer.
Incidence rates in children have stabilized since 2015 but continue to increase for adolescents by about 1 percent per year.
About 1 in 260 children will develop cancer before the age of 20.
In 2018, 17,293 children were diagnosed with cancer in the United States — approximately 47 children per day.
As of 2018, 4,317 children and teens under age 20 were diagnosed with CNS tumors, accounting for 25% of total cancer diagnoses in the age group 0-19.
The average age at diagnosis is 10 overall (ages 0 to 19), 6 years old for children (aged 0 to 14), and 17 years old for adolescents (aged 15 to 19), while adults’ average age for cancer diagnosis is 66.
Childhood cancer is not one disease - there are more than 12 major types of pediatric cancers and over 100 subtypes.
Most new cancer diagnoses in children are for leukemia (28.1%) and brain/CNS cancers (26.5%), while malignant epithelial neoplasms and melanomas (23.3%) and brain/CNS cancers (21.9%) are top cancers for adolescents.
It is estimated that there will be 13.7 million cases of childhood cancer between 2020-2050. Unless there are major improvements in diagnosis and treatments, of this, 45% will go undiagnosed and 11.1 million will die if no further investments in interventions are made. The vast majority, almost 85%, will be concentrated in developing countries.
Long-Term Health Effects Associated with Treatment and Survival
Cancer in children and young adults is different from cancer that develops later in life. Some of the unwanted side effects of cancer treatments cause more harm to children than they do to adults. This is because children's bodies are still growing and developing, so cancer and its treatment are more likely to affect developing organs.
More than 95% of childhood cancer survivors will have a significant health related issue by the time they are 45 years of age; these health related issues are side-effects of either the cancer or more commonly, the result of its treatment. 1/3 rd. will suffer severe and chronic side effects; 1/3rd will suffer moderate to severe health problems; and 1/3rd will suffer slight to moderate side effects.
Cognitive impairment affects up to one-third of childhood cancer survivors.
A large follow-up study of pediatric cancer survivors found that almost 10% developed a second cancer (most commonly female breast, thyroid, and bone) over the 30-year period after the initial diagnosis.
Female childhood cancer survivors who were treated with chemotherapy— even if they did not receive radiation treatments to their chest — are six times more likely than the general population to be diagnosed with breast cancer later in life. For those who did receive chest radiation, that chance increases exponentially and is on par with those who have the BRCA1 or BRCA2 mutations.
Childhood cancer survivors are at a 15-fold increased risk of developing Congestive Heart Failure and are at 7-fold higher risk of premature death due to cardiac causes, when compared with the general population. There is a strong dose-dependent relation between anthracycline chemotherapy exposure and CHF risk, and the risk is higher among those exposed to chest radiation.
Children who were treated for bone cancer, brain tumors, and Hodgkin lymphoma, or who received radiation to their chest, abdomen, or pelvis, have the highest risk of serious late effects from their cancer treatment, including second cancers, joint replacement, hearing loss, and congestive heart failure.
Life expectancy for five year childhood cancer survivors has steadily increased. Life expectancy for those treated in the 70’s is only 48.5 years and survivors treated in the 80’s have a life expectancy of 53.7 years, while those treated in the 90’s rose to 57.1 years. Normal life expectancy for adults is 80.
Nearly a quarter of childhood cancer survivors experience at least one debilitating neuromuscular condition 20 years post diagnosis.
Treatment, Research, Funding
On average, in 2009 pediatric hospitalizations principally for cancer were 8 days longer and cost nearly 5 times as much as hospitalizations for other conditions (12.0 days versus 3.8 days; $40,400 versus $8,100 per stay). Costs per day were about 70 percent higher for pediatric cancer stays ($3,900 versus $2,300 per day).
1 in 5 children who receive a new diagnosis of childhood cancer are already living in poverty.
One in four families lose more than 40% of their annual household income as a result of childhood cancer treatment-related work disruption, while one in three families face other work disruptions such as having to quit work or change jobs.
More than 90% of children and adolescents who are diagnosed with cancer each year in the United States are cared for at a children’s cancer center that is affiliated with the NCI-supported Children’s Oncology Group (COG). Each year, approximately 4,000 children who are diagnosed with cancer enroll in a COG-sponsored clinical trial.
Survival
The mortality rate has declined by more than half since 1970 in both children and adolescents but progress still lags for some types like DIPG. The overall 5-year survival rate between 2013-2019 was 85 percent among children and 87 percent among adolescents.
Cancer survival rates vary not only depending upon the type of cancer, but also upon individual factors attributable to each child.
Five year survival rates can range from almost 0% for cancers such as DIPG (2.2%) , a type of brain cancer, to as high as 90% for the most common type of childhood cancer known as Acute Lymphoma Leukemia (ALL).
There are more than 500,000 childhood cancer survivors in the United States.
Approximately 1 in 530 young adults between the ages of 20 and 39 is a survivor of childhood cancer.
Global 5-year net childhood cancer survival is currently estimated at 37.4%.
Mortality
Cancer is the number one cause of death by disease among children.
1,040 children (aged 0 -14) and 550 adolescents (aged 15-19) were expected to die from cancer in 2023 (excluding benign and borderline malignant brain tumors).
On average, about 14% of children die within 5 years of diagnosis. Among those children who survive to five years from diagnosis, 18% of them will die over the next 25 years.
The most common causes of death in childhood cancer survivors are: The primary cancer comes back. A second (different) primary cancer forms. Heart and lung damage.
Overall cancer death rates among children ages 0 to 14 years decreased an average of 1.4% per year.
Those that survive the five years have an eight times greater mortality rate due to the increased risk of liver and heart disease and increased risk for reoccurrence of the original cancer or of a secondary cancer.
There are approximately 70 potential life years lost on average when a child dies of cancer compared to 14 potential life years lost for adults.
Brain cancer represents 26% of total childhood cancer deaths while leukemia accounts for 28%.
Diffuse intrinsic pontine glioma (DIPG) represents approximately 80% of the malignant brainstem tumors occurring in children. Despite numerous clinical trials, the outcome of children with DIPG continues to remain dismal, with a median survival of only 11 months and a 2-year overall survival (OS) rate of less than 10%.
Worldwide, 100,000 children lose their lives every year to cancer. Children with cancer in low and middle-income countries are four times more likely to die of the disease than children in high-income countries.
Drug Development
Between the years of 2009 and 2019, nine of the 11 drugs used to treat acute lymphoblastic leukemia — which is the most common childhood cancer — were in and out of shortage.
While more than 200 cancer drugs have been developed and approved for adults, the FDA, through 2021 has approved a total of 35 drugs for use in the treatment of childhood cancers. 29 of the drugs were originally approved only for adult use. Today we have only six drugs that were approved in the first instance for use in cancer treatment for children.
The median lag time from first-in-human to first-in-child trials of oncology agents that were ultimately approved by FDA was 6.5 years.
Psychosocial Care
Childhood cancer threatens every aspect of the family's life and the possibility of a future, which is why optimal cancer treatment must include psychosocial care.
The provision of psychosocial care has been shown to yield better management of common disease-related symptoms and adverse effects of treatment such as pain and fatigue.
Depression and other psychosocial concerns can affect adherence to treatment regimens by impairing cognition, weakening motivation, and decreasing coping abilities.
For children and families, treating the pain, symptoms, and stress of cancer enhances quality of life and is as important as treating the disease.
Childhood cancer survivors reported higher rates of pain, fatigue, and sleep difficulties compared with siblings and peers, all of which are associated with poorer quality of life.
Changes in routines disrupt day-to-day functioning of siblings . Siblings of children with cancer are at risk for emotional and behavioral difficulties, such as anxiety, depression, and post traumatic stress disorder.
Symptoms of post-traumatic stress disorder (PTSD) are well documented for parents whose children have completed cancer treatment.
Chronic grief has been associated with many psychological (e.g., depression and anxiety) and somatic symptoms (e.g., loss of appetite, sleep disturbances, fatigue), including increased mortality risk.
Cancer survivors in the United States reported medication use for anxiety and depression at rates nearly two times those reported by the general public, likely a reflection of greater emotional and physical burdens from cancer or its treatment.
Financial hardship during childhood cancer has been found to affect a significant proportion of the population and to negatively impact family well being.
Adolescents with cancer experienced significantly more Health Related Hindrance (HRH) of personal goals than healthy peers, and their HRH was significantly associated with poorer health-related quality of life, negative affect, and depressive symptoms.
Peer relationships of siblings of children with cancer are similar to classmates, though they experience small reductions in activity participation and school performance.
Chronic health conditions resulting from childhood cancer therapies contribute to emotional distress in adult survivors.
Parents have been found to report significant worsening of all their own health behaviors, including poorer diet and nutrition, decreased physical activity, and less time spent engaged in enjoyable activities 6 to 18 months following their child’s diagnosis.
Sources: Coalition Against Childhood Cancer and the 2024 ACS Facts and Figures Report