Published online June 2, 2008
PEDIATRICS Vol. 121 No. 6 June 2008, pp. e1470-e1477 (doi:10.1542/peds.2007-2964)

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ARTICLE

Cancer Incidence Among Children and Adolescents in the United States, 2001–2003

Jun Li, MD, PhD, MPH^a,b, Trevor D. Thompson, BS^a, Jacqueline W. Miller, MD^a, Lori A. Pollack, MD, MPH^a and Sherri L. Stewart, PhD^a

^a Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
^b Epidemic Intelligence Service, Office of Workforce and Career Development, Atlanta, Georgia

OBJECTIVE. Our goal was to describe current childhood cancer incidence in the United States and identify demographic and geographic variation among children and adolescents with cancer.

METHODS. We examined data from 39 National Program of Cancer Registries and 5 Surveillance, Epidemiology, and End Results statewide registries (representing >90% of the US population) to identify cancers diagnosed among persons aged 0 to 19 from 2001–2003. Diagnosed cancers were grouped by the third version of the International Childhood Cancer Classification. Analyses were stratified according to gender, age, race, ethnicity, and US census region. A multivariable negative binomial regression model was used to evaluate demographic and geographic differences in incidence for all cancers combined.

RESULTS. We identified 36446 cases of childhood cancer with an age-adjusted incidence rate of 165.92 per million. Stratified analyses showed that, for all cancers combined, boys had a significantly higher rate than girls; children (aged 0–14 years) had a significantly lower rate than adolescents (aged 15–19 years); and white children had the highest incidence rate among all races. Young people living in the Northeast had the highest incidence rate among all US census regions, which may be partially attributed to significantly higher incidence rates for central nervous system neoplasms and lymphomas in this region compared with other US census regions. Negative binomial regression analysis demonstrated that the childhood cancer-incidence rate varied significantly according to gender, age, race, ethnicity, and geography.

CONCLUSIONS. This study is the first to demonstrate substantial regional differences in the incidence of childhood cancer. It also shows that incidence varies according to gender, age, race, and ethnicity. Our research findings are useful for prioritizing future childhood cancer research needs.

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Key Words: neoplasms • child • adolescent • pediatrics • SEER program

Abbreviations: NPCR—National Program of Cancer Registries • CDC—Centers for Disease Control and Prevention • SEER—Surveillance, Epidemiology, and End Results • ICCC—International Classification of Childhood Cancer • ICD-O—International Classification of Disease for Oncology • CNS—central nervous system • A/PI—Asian/Pacific Islander • AI/AN—American Indian/Alaska Native • CI—confidence interval • RR—rate ratio

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Accepted Jan 2, 2008.

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