Health - Childhood Cancer

Cancer in childhood is rare compared with cancer in adulthood, but still causes more deaths than any factor other than injuries among children ages 0 to 15 years. 

On this page: 

• Indicators
• About the Childhood Cancer Indicators
• Data Sources and Methods - Childhood Cancer
• Related Links

Indicators

H4: Childhood cancer incidence and mortality 

Web update: 2022

Key Information

• The annual incidence of childhood cancer has increased slightly over the last 30 years; however, mortality has declined significantly for many cancers due largely to improvements in treatment.
• In 2018, age-adjusted cancer incidence was 187 cases per million children. Cancer incidence has fluctuated over time but has generally increased since 1992, when the age-adjusted rate was 159 cases per million children.
• In 2018, childhood cancer mortality was at 22 deaths per million children, a decrease from 33 deaths per million children in 1992.
• Childhood cancer incidence and mortality rates are generally higher for boys than for girls.

H5: Childhood cancer incidence, by type

Web update: 2022

Key Information

• Leukemia represents 30% of total childhood cancer cases and was the most common cancer diagnosis for children ages 0 to 19 years in 2017-2018. Leukemia includes acute lymphoblastic leukemia (35 cases per million in 2017-2018) and acute myeloid leukemia (9 cases per million in 2017-2018).
• In 2017-2018, 19% of childhood cancers were central nervous system tumors (28 cases per million) and 15% of childhood cancers were lymphomas (22 cases per million children).
• Different types of cancer affect children at different ages. The incidence of neuroblastomas, central nervous system tumors, Wilms' tumor, and leukemias was highest for young children (ages 0 to 4 years). The incidence of lymphomas, thyroid carcinoma, other and unspecified carcinomas, soft tissue sarcomas, and Ewing’s sarcoma was highest in older children (ages 15 to 19 years).

About the Childhood Cancer Indicators

Cancer in childhood is rare compared with cancer in adulthood, but still causes more deaths than any factor, other than injuries, among children ages 0 to 15 years. The annual incidence of childhood cancer has increased slightly over the last 30 years; however, mortality has declined significantly for many cancers due largely to improvements in treatment.

The causes of cancer in children are poorly understood, though in general it is thought that different forms of cancer have different causes. According to scientists at the National Cancer Institute, established risk factors for the development of childhood cancer include family history, specific genetic syndromes (such as Down syndrome), high levels of radiation, and certain pharmaceutical agents used in chemotherapy. A number of studies suggest that environmental contaminants may play a role in the development of childhood cancers. The majority of these studies have focused on pesticides and solvents, such as benzene. Studies have also suggested an association between childhood exposures to multiple hazardous air pollutants and leukemia. According to the U.S. Surgeon General, there is also suggestive evidence that prenatal and postnatal exposure to environmental tobacco smoke can lead to leukemia, lymphomas, and brain tumors in children.

Environmental exposures in childhood can also increase the risk of cancer in adulthood, though the types of cancers seen later in life may differ. According to the National Cancer Institute, the most common forms of cancer among adults are breast cancer, prostate cancer, and lung cancer.

For historical and contextual information about childhood cancer and these indicators, see the  Childhood Cancer section of America's Children and the Environment, Third Edition (pdf) (1.07 MB) .

Data Sources and Methods - Childhood Cancer

The National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program collects and publishes data on cancer incidence, survival, and prevalence. SEER obtains its cancer case data from population-based cancer registries that currently cover a total of 17 geographical areas in the United States and one quarter of the population. SEER obtains its cancer mortality data from a national database of vital statistics that collects data on numbers and causes of all deaths each year.

Indicator H4 uses the SEER data to present childhood cancer incidence and mortality for children ages 0 to 19 years. Indicator H5 uses the SEER data to present the number of childhood cancer cases reported for children ages 0 to 19 years, stratified by type. The incidence rate is age-adjusted, meaning that each year's incidence calculation uses the age distribution of children from the year 2000. Some types of childhood cancers are very rare, and as such the yearly incidence is particularly low and variable. Due to this fact, Indicator H5 shows the incidence of individual childhood cancers in groupings of four years.

• Detailed Methods for Indicators H4 and H5 (pdf) (1.54 MB)
• Metadata for National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program

Related Links

• U.S. EPA: EPA Efforts to Reduce Exposure to Carcinogens and Prevent Cancer
• National Cancer Institute (NCI): Childhood Cancer
• National Cancer Institute (NCI): Cancer Incidence and Survival Among Children and Adolescents: United States SEER Program 1975-1995
• National Cancer Institute (NCI): Reducing Environmental Cancer Risk - What We Can Do Now (PDF)
• National Cancer Institute (NCI): SEER Cancer Statistics Review
• U.S. Department of Health & Human Services (HHS): The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General