Although advances in the treatment of childhood cancer have saved many lives in recent decades, there has been less progress in understanding the causes and prevention of childhood and adolescent cancers, according to a report by the American Cancer Society.
The report estimates the number of new cancer cases and deaths for children and adolescents in the U.S., summarizes the most recent and comprehensive data on cancer incidence, mortality and survival, and outlines what is known and where answers still are needed for childhood cancers.
The American Cancer Society created the report, which was published Jan. 31 on the website of CA: A Cancer Journal for Clinicians and as a special section in Cancer Facts & Figures 2014, to inform clinicians and the public about progress and challenges in preventing and averting suffering and death from cancers that affect children and adolescents.
Although there have been substantial improvements in survival for many cancers of childhood, according to the report, others have seen little progress. For example, progress against central nervous system cancers has been significant overall, but survival times remain tragically low for some subtypes. For diffuse intrinsic pontine glioma, the median survival time after diagnosis remains less than a year.
In 2014, an estimated 15,780 new cases of cancer will be diagnosed and 1,960 deaths will occur among children and adolescents ages 0 to 19, according to the report. Annual incidence of cancer from birth to age 19 is 18.8 per 100,000; approximately one in 285 children will be diagnosed with cancer before age 20. About one in 530 young adults between ages 20 and 39 is a childhood cancer survivor.
While advances in survival for many types of malignancies have resulted from advances in surgical techniques, delivery of radiation therapy and use of chemotherapy, children treated for many cancers have a high risk of long-term health issues.
For example, children treated for brain tumors, a leading cancer in children, may experience seizures, weakness in the arms and legs, blindness, hearing loss, neuroendocrine effects that include growth hormone deficiency, hypothyroidism, abnormal timing of menarche and neurocognitive deficits. Other cancers and their treatments also have serious long-term effects.
Unlike adult cancers, only a relatively small percentage of all childhood cancers have known preventable causes. Also, early detection of cancer in children is made much more difficult because of the similarity of some symptoms to those of more common childhood diseases.
Some symptoms of childhood cancer that should alert parents and healthcare providers include an unusual mass or swelling; unexplained pallor or loss of energy; a sudden tendency to bruise; a persistent, localized pain or limping; a prolonged, unexplained fever or illness; frequent headaches, often with vomiting; sudden changes in vision; and excessive, rapid weight loss.
Progress in childhood cancer has been dramatic for some sites, but we cannot let that blind us from the fact that progress has been disappointingly slow for other sites, and that cancer remains the second leading cause of death in children, Otis W. Brawley, MD, American Cancer Society chief medical officer, said in a news release. There is much work to be done to improve outcomes, to reduce side effects associated with cancer and its treatment and, we hope, to understand more about the molecular events that lead to childhood cancer in order to come up with ways to prevent or detect it early.
It is important to recognize that all of the issues identified in this report, including the long-term and late effects of cancer treatment, came about due to the foresight and dedication of pediatric oncologists, researchers and other health professionals who have dedicated their lives to fighting these deadly cancers, lead author Elizabeth Ward, PhD, said in the news release.