A Snapshot of Pediatric Cancers
Incidence and Mortality
Cancer is the leading cause of death by disease among U.S. children between infancy and age 14. Approximately 11,600 new cases of pediatric cancer are expected to be diagnosed in children ages 0–14 years in 2013. The major types of childhood cancers are leukemia and brain and other central nervous system (CNS) tumors, which account for more than half of new cases. White and Hispanic children are more likely than children from any other racial or ethnic group to develop cancer.
Although the overall incidence rate of invasive cancer in children has increased slightly over the past 30 years, mortality rates have declined by more than 50 percent for many childhood cancers.1 The combined 5-year survival for all childhood cancers has improved from 63 percent in the mid-1970s to 83 percent in recent years. The progress in survival rates is largely attributable to improvements in treatments and to the high proportion of pediatric patients participating in clinical trials. Although outcomes have improved for many childhood cancers, progress in others has been limited. Brain tumors remain the leading cause of cancer-related death in children.
The causes of most childhood cancers are unknown, and for the most part they cannot be prevented. In rare cases, children who are at increased risk of developing a certain cancer (for example, colorectal cancer) due to inherited genetic alterations may have surgery to reduce this risk. Depending on the type of cancer, children may receive different standard treatments, including surgery, chemotherapy, cerebrospinal fluid diversion, radiation therapy, watchful waiting, chemotherapy with stem cell transplant, biological therapy, or targeted therapy.
Examples of NCI Activities Relevant to Pediatric Cancers
- The Therapeutically Applicable Research to Generate Effective Treatments (TARGET) initiative is identifying prognostic markers and therapeutic targets to develop new, more effective treatments for children with pediatric cancers.
- The Pediatric Preclinical Testing Program (PPTP) evaluates new agents against childhood solid tumor and leukemia models.
- The NCI-supported Childhood Cancer Survivor Study is following more than 14,000 childhood cancer survivors, with approximately 4,000 siblings of survivors serving as control subjects, to assess mortality rates, to determine risks of developing subsequent cancers, and to better understand the long-term effects of cancer treatments on the heart, the lungs, and fertility.
- The Center for Cancer Research's Pediatric Oncology Branch conducts basic science research and clinical trials to improve outcomes for children with cancer or genetic tumor predisposition syndromes.
- In collaboration with the Children's Oncology Group, NCI is conducting a number of studies of Genetic Modifiers of Osteogenic Sarcoma to identify genetic variants that are linked to the risk of developing this bone cancer, which has peaks in incidence both in early adolescence and in later life.
- NCI's Epidemiology and Genetics Research Program supports three Childhood Cancer Epidemiology Consortia that conduct multidisciplinary research on childhood cancer risk factors.
Selected Advances in Pediatric Cancers Research
- Gene rearrangements identified through whole-genome sequencing of Philadelphia-chromosome-like acute lymphoblastic leukemia, a high-risk childhood cancer subtype, produce activated proteins that are potential targets for existing therapeutics. Published August 2012. [PubMed Abstract]
- A multi-institutional team identified a growth factor that, together with its receptor, is essential for the growth and spread of medulloblastoma, the most common malignant pediatric brain tumor. Published February 2013. [PubMed Abstract].
- Scientists developed the first pediatric adrenocortical carcinoma (ACC) xenograft model and identified a potential drug to treat children with ACC. Published February 2013. [PubMed Abstract]
- Results of a phase I clinical trial of crizotinib showed that this drug has antitumor activity in pediatric cancer patients whose tumors have activating mutations in the ALK gene. Published April 2013. [PubMed Abstract]
- See this PubMed list of selected free full-text journal articles on NCI-supported research relevant to pediatric cancer. You can also search PubMed for additional scientific articles or to complete a search tutorial.
Trends in NCI Funding for Pediatric Cancers Research
The National Cancer Institute's (NCI) investment2 in pediatric cancers research increased from $189.8 million in fiscal year (FY) 2008 to $208.1 million in FY 2012. In addition to this funding, NCI supported $60.4 million in pediatric cancers research in FY 2009 and FY 2010 using funding from the American Recovery and Reinvestment Act (ARRA).
Additional Resources for Pediatric Cancers
- NCI Childhood Cancers Home Page
NCI's gateway for information about pediatric cancers.
- Childhood Cancers Fact Sheet
A fact sheet about trends in childhood cancers in the United States and NCI's current research on childhood cancers.
- Young People with Cancer: A Handbook for Parents
Overview on the diagnosis and treatment of childhood cancers, including common medical procedures and side effects. Suggests ways to talk with children about cancer, support family life, and manage practical issues.
- PDQ® Cancer Information Summaries: Pediatric Treatment
Treatment options for childhood cancers.
- Late Effects of Treatment for Childhood Cancer (PDQ®)
Expert-reviewed information summary about the health problems that continue or appear after cancer treatment has ended.
- 1 Includes cancers in children 0-18 years of age. Does not include research on pediatric AIDS, infant mortality, science enrichment, or anti-smoking.
- 2 The estimated NCI investment is based on funding associated with a broad range of peer-reviewed scientific activities. For additional information on research planning and budgeting at the National Institutes of Health (NIH), see About NIH.