Declining Childhood and Adolescent Cancer Mortality
Malcolm A. Smith, MD, PhD; Sean F. Altekruse, DVM, PhD; Peter C. Adamson, MD; Gregory H. Reaman, MD; and Nita L. Seibel, MD
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Treatment of childhood cancer is 1 of the important success stories of 20th century medicine. This success is exemplified by acute lymphoblastic leukemia (ALL), an incurable disease in the 1950s that, by the end of the century, had 5-year survival rates approaching 90%. Other childhood cancers also exhibited marked improvements in outcome in the 20th century, including Wilms tumor, non-Hodgkin lymphoma (NHL), Hodgkin lymphoma, and germ cell tumors.
Despite the successes in identifying effective treatments for some cancer diagnoses, at the end of the 20th century, >20% of children diagnosed with cancer still died from their disease, and many survivors experienced long-term effects that negatively affected their quality of life. In addition, for some childhood cancers, progress was very limited (eg diffuse intrinsic brainstem gliomas, high-grade gliomas, andmetastatic sarcomas).Of concern, a slowing in the rate of decline in childhood cancer mortality has been described for both European and North American populations, suggesting that a plateau is being reached in the ability of childhood cancer researchers to identify more effective treatments for children with cancer.1,2 To ascertain whether progress in identifying more effective treatments for children and adolescents with cancer is continuing, we examined overall and disease-specific childhood cancer mortality rates for the United States, focusing onmore recent data from 2000 to 2010.
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