Nearly nine in 10 young people with cancer were alive five years after diagnosis by 2017, up from six in 10 in 1975, according to the first comprehensive update of U.S. childhood cancer survival statistics in more than a decade, published in the „Journal of the National Cancer Institute“ (DOI: 10.1093/jnci/djag155). However, the progress did not reach everyone equally: some cancers, such as certain leukemias and bone or soft tissue cancers (sarcomas), improved much less than others, and Black children and teenagers had worse survival across most cancer types.
„Our study shows that childhood cancer is one of modern medicine’s greatest success stories,“ said lead author Lindsay Schwartz, pediatric oncologist at Ann & Robert H. Lurie Children’s Hospital of Chicago and Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine. Molecularly targeted agents and immunotherapies have increasingly been integrated into treatment and may have improved survival among young patients not cured with conventional chemotherapy while reducing late mortality from toxic treatments, she said. Survival gains were also likely driven by advances in precision diagnostics, risk stratification and inclusive cooperative group trials. „Our findings, however, also point to where children and families still need us to do better.“
Schwartz and colleagues examined registry data covering more than 100,000 children and teenagers aged 0 to 19 diagnosed with cancer in the U.S. between 1975 and 2022, using data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results databases. They evaluated trends in five-year overall survival among different sociodemographic groups. From 2000 to 2017, five-year overall survival for all cancer types combined was 88 percent for non-Hispanic White patients, 84.5 percent for Hispanic patients, 85.6 percent for patients of other races and ethnicities, and 80.8 percent for non-Hispanic Black patients.
Disparities also emerged by cancer type. Five-year survival for acute lymphoblastic leukemia (ALL), the most common childhood cancer, rose from 43 percent in 1975 to 95 percent in 2017. Survival for acute myeloid leukemia (AML) is still around 72 percent, and for sarcomas around 74 percent. „For AML, sarcomas and high-risk neuroblastoma, children still need new and better treatments, and research on them should be a priority,“ Schwartz said. „We still need to learn why survival gaps persist.“ The reasons are probably a mix of factors, including access to care, insurance, where families live, how the cancer behaves biologically and treatment side effects. Learning which matters most is key to making sure every child benefits from medical advances.
Five-year survival was not the whole story: some survivors, especially young people treated for Hodgkin lymphoma decades ago, die at higher rates 20 to 30 years after their cancer was cured, often from long-term effects of treatment. People treated for Hodgkin lymphoma in the 1970s and early 1980s had 87 percent survival at five years after diagnosis, but only 63 percent at 30 years. „Families and doctors should know that lifelong follow-up care after cancer matters, including screening for second cancers and heart problems,“ Schwartz stressed. Collectively, the findings underscore the need for continued progress not only in developing effective and less toxic therapies but also in ensuring these advances are accessible to every child and adolescent with cancer. The work was supported by the National Cancer Institute, the National Center for Advancing Translational Sciences, the U.S. Department of Defense, Alex’s Lemonade Stand Foundation and the National Clinical Trials Network Operations Center Grant for the Children’s Oncology Group.
