13 the burden system tumors nervous system sarcomas … · 2019-12-19 · by region leukemia...
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Leukemia
Lymphomas
Central nervoussystem tumors
Sympatheticnervous system
Soft tissuesarcomas
Other neoplasms
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
Leukemia
Lymphomas
Central nervoussystem tumors
Sympatheticnervous system
Soft tissuesarcomas
Other neoplasms
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
Leukemia
Lymphomas
Central nervoussystem tumors
Sympatheticnervous system
Soft tissuesarcomas
Other neoplasms
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
Leukemia
Lymphomas
Central nervoussystem tumors
Sympatheticnervous system
Soft tissuesarcomas
Other neoplasms
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
Leukemia
Lymphomas
Central nervoussystem tumors
Sympatheticnervous system
Soft tissuesarcomas
Other neoplasms
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
Leukemia
Lymphomas
Central nervoussystem tumors
Sympatheticnervous system
Soft tissuesarcomas
Other neoplasms
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
FIGURE 4Age-standardized cancer incidence rates (world) per million population by region, children age
0-14 years, 2001-2010
Other neoplasms Soft tissue sarcoma Sympathetic nervous systemCNS tumours Lymphomas Leukaemia
Native American
Asian & Pacific Islander
Black
White Hispanic
White Non-Hispanic
0 20 40 60 80 100 120 140 160 180 200 220 240
canceratlas.cancer.org
Leukemia
Lymphomas
Central nervoussystem tumors
Epithelial tumours& melanoma
Germ cell &gonadal tumours
Other neoplasms
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
Leukemia
Lymphomas
Central nervoussystem tumors
Epithelial tumours& melanoma
Germ cell &gonadal tumours
Other neoplasms
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
Leukemia
Lymphomas
Central nervoussystem tumors
Epithelial tumours& melanoma
Germ cell &gonadal tumours
Other neoplasms
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
Leukemia
Lymphomas
Central nervoussystem tumors
Epithelial tumours& melanoma
Germ cell &gonadal tumours
Other neoplasms
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
Leukemia
Lymphomas
Central nervoussystem tumors
Epithelial tumours& melanoma
Germ cell &gonadal tumours
Other neoplasms
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
ASR per million
FIGURE 5Age-standardized cancer incidence rates (world) per million population by region, children age
15-19 years, 2001-2010
Other neoplasms Germ cell & gonadal tumours Epithelial tumours & melanomaCentral nervous system tumors Lymphomas Leukemia
Native American
Asian & Pacific Islander
Black
White Hispanic
White Non-Hispanic
0 20 40 60 80 100 120 140 160 180 200 220 240
canceratlas.cancer.org
5-year net survival (%)
FIGURE 75-year age-standardised net survival (%) for children aged 0–14 years diagnosed
with acute lymphoid leukemia, select countries 1995-2009
Colombia, Cali
Thai registries
Bulgaria
Turkey, Izmir
South Korea
Belarus
UK
Australia
USA
France
40 50 60 70 80 90 100
canceratlas.cancer.org
Leukemia
Lymphomas
Central nervoussystem tumors
Epithelial tumours& melanoma
Germ cell &gonadal tumours
Other neoplasms
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
0 20 40 60 80
canceratlas.cancer.org canceratlas.cancer.org
13 THE BURDEN
CANCER IN CHILDRENThe childhood cancer burden is strongly related to level of development, with high incidence in high-income countries but higher mortality in low-income countries.
The true burden of cancer in children is unknown in most
low-income countries.
FIGURE 13.1
Percentage (%) of the population in which frequency of cancer is measured on each continent in children (age 0–14 years) and adolescents (age 15–19 years)
15.7 9.2
LATIN AMERICA
Children Adolescents
5.3 2.6
AFRICA
Children Adolescents
97.2 98.1
NORTH AMERICA
Children Adolescents
66.4 46.1
EUROPE
Children Adolescents
6.3 5.3
ASIA
Children Adolescents
59.5 64.7
OCEANIA
Children Adolescents
More than half of long-term survivors of childhood cancer
experience chronic health conditions.
FIGURE 13.4
Five-year age-standardized net survival (%) observed in the available cohorts of cases diagnosed with lymphoid leukemia
5-year survival (%)
FIGURE 6Five-year age-standardized net survival
(%) in children aged 0-14 yearsdiagnosed with lymphoid leukaemia
Western Europe
Oceania
North America
Northern Europe
Southern Europe
Eastern Europe
East Asia
West Asia
Latin America
Southeast Asia
Africa
40 60 80 10020
canceratlas.cancer.orgSurvival from lymphoid leukemia is over 80%
in more developed regions.
Cancers occurring in childhood and adolescence differ markedly from cancers in adults in their incidence and tumor characteristics. Worldwide, the average annual incidence in children aged less than 15 years is 140 new cases per million children, although there are threefold variations between world regions and ethnic groups. FIGURE 13.2 The low rates recorded by population-based cancer registries in some low-income countries are thought to result from under-diagnosis. FIGURE 13.1
The most common cancers in children are leukemia and lymphoma, while the major cancers among adults, such as carcinoma of the lung, breast or colon, are rare in children. The incidence of carcinomas increases progressively with age, and together with lymphomas or germ cell tumors they become the most common cancers in adolescents aged 15–19 years, with the overall incidence rate rising to 185 per million. In contrast, the incidence of embryonal tumors, such as neuroblastoma, retinoblastoma, and nephroblastoma is very low in adolescents. FIGURE 13.3
The incidence of cancer in children and adolescents has been increasing by 0.5 to 1 percent per year in the high-income countries with established cancer registries over the past few decades. Although the increase may in part reflect more frequent diagnosis facilitated by advanced imaging techniques, other factors may have also contributed. Exposures to high doses of ionizing radiation, high birth weight and certain genetic syndromes have been consistently associated with increased risk of cancer in children. The role of other risk factors, such as air pollutants, tobacco or pesticide use, older parental age, or fewer children per family is debated. Potentially protective effects of breastfeeding and folate supplementation are being investigated.
More than 80% of childhood cancer patients in high-income countries survive 5 years after their diagnosis. In many low-income countries, in contrast, the outlook is much less favorable because of suboptimal access to care, late diagnosis, treatment abandonment, inadequacy of therapy, and the financial burden. Survival of childhood cancer patients has been assessed in only a few low-income countries. FIGURE 13.4
As survival of cancer patients improves over time FIGURE 13.5, many survivors experience chronic health conditions later in life as a consequence of their cancer or the anti-cancer therapy.
FIGURE 13.2
Age-standardized cancer incidence rates (world) per million population, 2001–2010
FIGURE 13.3
BY ETHNIC GROUP (US)
BY ETHNIC GROUP (US)
CHILDREN AGE 0–14 YEARS
15–19 YEARS
Age-standardized cancer incidence rates (world) per million population, 2001–2010
FIGURE 13.5
Changes in 5-year age-standardized net survival (%) for children aged 0–14 years diagnosed with acute lymphoid leukemia, select countries 1995–2009
Periods of diagnosis
1995–1999
2005–2009
41% 52%
82% 89%
Occurrence of childhood cancer varies by region,
with the highest incidence in more developed regions.
The distribution of cancer in adolescents differs from that of
children and adults.
Sub-Saharan AfricaNorth Africa
South Asia (India only)East Asia
Southeast Asia West Asia
Latin AmericaNorth America
Europe
Oceania
Sub-Saharan AfricaNorth Africa
South Asia (India only)East Asia
Southeast Asia West Asia
Latin AmericaNorth America
Europe
Oceania
BY REGION Leukemia LymphomasCentral nervous system tumors
Sympathetic nervous system
Soft tissue sarcomas
Other neoplasms
BY REGION Leukemia LymphomasCentral nervous system tumors
Epithelial tumors & melanoma
Germ cell & gonadal tumors
Other neoplasms
78
children43% survival
11,014 children
88% survival
Burkitt lymphoma is the most common pediatric cancer in many parts of sub-Saharan Africa. While about
90% of children with Burkitt lymphoma in high-income countries
can be cured with timely treatment including high-intensity chemotherapy and supportive
care infrastructure, about 50% of children with the disease in resource-constrained settings
where such treatment is not feasible can be cured with a simplified protocol.
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5-year survival (%) circle size indicates number of cases
copyright © 2019 the american cancer society, inc.