Cancer Trends 32 - Childhood cancer

The latest short report from the National Cancer Registry, published today, notes increases in incidence of childhood cancer between 1994 and 2014, partly reflecting population increases and diagnostic improvements, but ongoing major reductions in mortality.

  • On average, 137 cases of cancer were diagnosed per year among children under age 15 during the 21-year period 1994-2014 (or 211 per year under age 20 i.e. children and older adolescents). Average annual numbers rose from 117 per year during 1994-2000 to 163 per year during 2008-2014, partly reflecting increases in the childhood population (especially under age 5). All statistics presented below relate to the under-15 (‘childhood’) group.
  • For boys and girls combined, age-standardised incidence rates (taking account of changes in population size and age) for all childhood cancers combined increased significantly by, on average, 1.1% per year between 1994 and 2014.  For girls the increase was 1.6% per year, and was also significant, whereas for boys the trend was not statistically significant (+0.6% per year). Although a real trend in underlying risk of childhood cancer cannot be ruled out, it is likely that a substantial proportion of the increase in incidence rates reflects improvements in diagnosis.
  • Of the three biggest cancer groups in children, leukaemias and lymphomas show no significant trends in incidence, but tumours of the brain and CNS showed a significant increase from 1999 to 2014 following an earlier, non-significant decrease.
  • Childhood cancer mortality rates have declined significantly and substantially since the mid to late 1960s, by on average 2.5%-3% per year, and fewer than 25 children under 15 have died from cancer per year from the 1990s onwards, compared with 50-60 per year from the 1950s to the 1970s.
  • Five-year survival from childhood cancer as a whole has averaged 81% in the most recent ten years, and has been high throughout the period from 1994 onwards. Statistically significant improvements have been seen in survival from leukaemias (especially lymphoid leukaemia) and lymphomas during the last 20 years, but the main improvements in childhood cancer survival probably pre-date 1994.
  • Of the 2,873 patients aged 0-14 diagnosed with cancer during 1994-2014, most (2,289) were still alive at the end of 2014. The majority of survivors had been diagnosed with leukaemias (31%) or brain / central nervous system tumours (23%), similar to the breakdown among newly diagnosed cancers. These figures exclude unknown (but probably substantial) numbers of survivors of childhood cancers diagnosed before 1994.
  • While incidence rates of childhood cancer in Ireland were close to the observed European average, mortality rates in Ireland were amongst the lowest observed; average survival among patients in Ireland was close to the European average.

Commenting on the report’s findings, Professor Kerri Clough-Gorr, Director of the National Cancer Registry noted: Although childhood cancers are thankfully rare, their impact on families is high, and the potential loss of years of life averages much higher than for adult cancers. Monitoring of trends in these cancers is therefore important. While incidence appears to be increasing, the consensus internationally is that this may, to a large extent, reflect improvements in diagnosis. Treatment improvements have led to marked reductions in mortality from childhood cancer, but further work is needed to follow-up the growing numbers of survivors of childhood cancer, who may experience long-term health consequences related to their cancer treatment.”

The full report can be downloaded here.

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