Childhood cancer statistics - trends

Since 1962 there have been gradual changes in childhood cancer registration and death rates in Britain ( Figure Six1). Registration rates increased by 0.8% per year on average between 1962 and 1998, a total increase of 35%.

Figure Six: Trends in age-standardised (uniform population) cancer registration and death rates, children aged 0-14 years, Great Britain, 1962-1997

As a result of improvements in survival, death rates fell by 2.6% per year on average between 1962 and 2001, a reduction of more than half.

Improvements in the efficiency of systems for the diagnosis and registration of cancer may have contributed to the increase in registration rates. In the past some children may have been recorded as dying of non-cancer causes that were in fact related to an underlying undiagnosed cancer.

It has also probably become easier to track and record the diagnosis of new patients as treatment has become more centralised. The amount of real change, if any, in the underlying incidence rates is not clear.

There were differences in registration trends between diagnostic groups. For example, from 1963 to 1997 the average annual increase in the age-standardised registration rate was 0.6% per year for leukaemias and lymphomas, 1.0% for brain and spinal tumours, and 1.4% for bone and soft tissue sarcomas combined ( Figure Seven1).

Figure Seven: Registration rates for successive calendar periods, expressed as proportions of the rate for 1963-67, children aged 0-14, Great Britain 1963-97

The considerable reduction in childhood cancer mortality in Britain since the 1960s in spite of stable or increasing incidence rates reflects dramatic improvements in survival. Only about 25% of children with cancer diagnosed in Britain during the decade 1962-1971 survived for more than five years. Nearly 75% of those diagnosed during 1992-96 survived for more than five years ( Figure Eight1).

Figure Eight: Survival of childhood cancer patients diagnosed in successive periods, Great Britain, 1962-96

The initial large improvements followed the introduction of combination chemotherapy in the late 1960s and early 1970s.

Since then, clinical trials have contributed to the testing and rapid adoption of refinements in diagnosis and treatment, and the gradual centralisation of specialised care has ensured that the great majority of patients in Britain receive the currently best treatment.

The most impressive improvement is in the most frequent type of childhood cancer, ALL: the proportion of patients in Britain who were still alive five years after diagnosis has increased from 12% of those diagnosed during the decade 1962-71 to more than 80% of those diagnosed in 1992-96.

There have been striking improvements in almost all the other common diagnostic groups too; for example from 21% to over 75% in non-Hodgkin lymphomas, from 17% to more than 50% in neuroblastoma, and from 35% to more than 80% in Wilms’ tumour ( Figure Nine1).

Figure Nine: Five-year survival rates for childhood cancers, showing cumulative improvements for patients diagnosed in successive periods, Great Britain 1962-96

In the Nordic countries subsequent mortality among 5-year survivors of childhood cancer diagnosed in the 1980s was over a third less than for those diagnosed in the 1960s and 1970s and the impressive gains in survival were not offset by any increase in treatment related mortality 2.

The improvement in survival rates, combined with stable or increasing incidence, has resulted in there being a large increase in the number of people who have been affected by childhood cancer and are still alive ( Figure Ten1).

At the end of 1961 there were probably fewer than 2,500 people of all ages living in Britain who at some time in the past had been diagnosed with childhood cancer. At the end of the year 2000 there were more than 26,000.

Figure Ten: Number of people in the specified age group alive at the end of each calendar year who had previously had a diagnosis of childhood cancer, Great Britain 1961-2000