Annual Report to the Nation Finds Decline In Deaths and Rising Cancer Incidence
The Annual Report to the Nation on the Status of Cancer was recently issued by the American Cancer Society, Centers for Disease Control and Prevention, National Cancer Institute, and North American Association of Central Cancer Registries. The report, published in JNCI: Journal of the National Cancer Institute, finds that overall cancer incidence rates continue to increase among females, children, and adolescents and young adults (AYAs). The report includes trends for the most common cancers among children (aged 0-14), and adolescents and young adults (aged 15-39) – leukemia, brain and other nervous system, and lymphoma. While death rates have decreased among children and AYAs, between 2014 and 2018, incidence rates have increased an average of 0.7%-0.8% per year from 2001-2017.
Despite the overall increase in cancer incidence rates among AYAs, there were decreases for lymphoma and melanoma. The data also show variability in incidence trends among different racial/ethnic groups, with leukemia incidence showing the most variability, ranging from a low among Black children, to the highest rates among Hispanic children. The overall cancer death rate for the most common cancers decreased an average of just under 1% per year among AYAs, and an average of 1.4% per year among children between 2014 and 2018. During 2001-2017, death rates among children for brain and other nervous system (ONS) cancer were stable, while death rates from leukemia declined an average of 2.9% per year.
In response to these findings, Dan Wechsler, MD, PhD, Professor of Pediatrics & Director of Pediatric Oncology at Emory University School of Medicine, and a Board member of Children’s Cancer Cause, stated, “It is certainly encouraging to see that overall death rates for some cancers in children are stable or decreasing, a tribute to the ongoing collaborative efforts of pediatric oncologists around the country through the Children’s Oncology Group (COG). At the same time, the reasons for the slight increases in incidence rates for leukemias, lymphomas, and brain cancer are unclear – these could be related to changes in disease classification or diagnostic procedures, or more ominously, to increased obesity or exposure to radiation. It is important that we continue to try to minimize exposure to diagnostic radiation and to encourage healthy lifestyles in our patients.”
Other Key Findings:
The annual increase in AYA colorectal cancer incidence rates almost tripled from 1.8% during 2001-2011 to 5.5% during 2011-2017.
Female breast cancer is the most commonly diagnosed cancer among AYAs, with incidence rates stable during 2001-2010 then increasing 1.1% per year during 2010-2017.
Overall death rates among AYA declined during 2001-2018, yet the death rate among AYAs was highest among Black and AI/AN AYAs.
Death rates from breast cancer were twice as high for black AYAs as for white AYAs.
Death rates for AYA female breast cancer declined an average of 3.2% per year during 2001-2010 and then stabilized during 2010-2018.
During 2001-2018, death rates increased 0.9% per year on average for AYA colorectal cancer, whereas rates decreased 2.2% per year for leukemia and were stable for brain and ONS cancer.
The report notes that these increases in childhood cancer incidence overall and for major cancer types may be due in part to increases in certain risk factors, including obesity and radiation, while cautioning that other factors may have also contributed to these trends. The report states that “These findings inform efforts related to prevention, early detection, and treatment and for broad and equitable implementation of effective interventions, especially among under-resourced populations.”
“The racial and ethnic disparities in cancer outcomes are of particular concern and warrant attention and resources to understand why some patients from different backgrounds are less likely to be cured,” Dr. Wechsler added “There are likely both biological and social determinants of these different outcomes and we need to devote more energy to studying cancers in different populations with the goal of improving their prognoses.”
While the findings of this year’s annual report on the status of cancer continues to reveal some promising trends for children and AYAs, the increased incidence for the most common cancers among these populations is of concern. Despite the decreases in death rates, the variability among different racial/ethnic groups is also cause for concern and points to the need to address these disparities where they occur.
Children’s Cancer Cause is dedicated to monitoring, advocating, and disseminating information about vital national issues facing children with cancer and their families. We act as a catalyst to stimulate pediatric drug discovery and development and to help ensure care for survivors of childhood and adolescent cancer. We will continue to press for progress for national policies that can give our children access to the most effective therapies and can normalize their lives as they grow into adulthood.