Childhood and Adolescent Cancer Survival in the US by Race and Ethnicity for the Diagnostic Period 1975-1999

BACKGROUND. Survival trends provide a measure of improvement in detection and treatment over time. In the current study, updated childhood and adolescent cancer survival statistics are presented, overall and among demographic subgroups, including Hispanics, for whom to the authors' knowledge national rates have not been previously reported. These results extend those provided by the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program in their detail and interpretation. METHODS. Survival trends of primary cancers in children and adolescents (ages birth to 19 years) were evaluated using SEER 9 data. Five-year and 10-year relative survival rates across 5-year (1975-1979, 1985-1989, and 1995-1999) and 10-year (1975-1984 and 1985-1994) cohorts were compared via Z-tests. Annual percent change (APC) in survival was computed via weighted least-squares regression. Rates in Hispanic children and adolescents were compared with those in non-Hispanic whites and blacks (SEER 13, 1995-1999). RESULTS. Five-year survival rates increased significantly overall (1975-1979: 63% vs 1995-1999: 79%; P < .0001) and for nearly all histologic types examined; increases were greatest for ependymoma (+37%; P < .0001) and non-Hodgkin lymphoma (+34%; P < .0001). Hispanic children and adolescents had somewhat poorer 5-year rates than non-Hispanic whites overall (74% vs 81%; P < .0001) and for Ewing sarcoma, leukemia, central nervous system tumors, and melanoma. Ten-year rates also increased significantly overall (1975-1984: 61% vs; 1985-1994: 72%; P < .0001) and for a majority of cancer types. The largest improvements were noted for acute lymphoblastic leukemia (+19%; P < .0001) and non-Hodgkin lymphoma (+19%; P < .0001). CONCLUSIONS. Observed trends reinforce the need for resources devoted to advancing treatment modalities, reducing disparities among racial/ethnic groups and adolescents, and providing long-term care Of Survivors. Cancer 2008;113: 2575-96. (C) 2008 American Cancer Society.