Trends in Childhood and Adolescent Cancer Incidence Rates in the United States between 2001 and 2022

We estimated trends in age-standardized childhood and adolescent cancer rates between 2001 and 2022 using national data from the United States Cancer Statistics database. The incidence of cancer in 0- to 19-year-olds was 18.2 per 100,000 with rates increasing by 0.94% per year between 2001 and 2016 and then decreasing by 0.96% per year during 2016 to 2022. Lymphoma rates increased by 0.49% per year during 2001 to 2022, whereas trajectories of other cancers varied over time. Leukemia rates increased by 1.03% per year during 2001 to 2010 and then plateaued. Rates of central nervous system (CNS) tumors increased by 0.81% per year during 2001 to 2014 and then declined by 2.10%/year during 2014 to 2022. Rates of other epithelial neoplasms were stable from 2001 to 2013, increased in 2013 to 2016, and were stable during 2016 to 2022. There were an estimated 1,040 additional childhood cancer diagnoses in 2022 compared with what would have been expected based on 2001 rates. Modifications in cancer classifications, screening practices, and diagnostic technology likely contributed to the observed changes, in addition to the potential contributions of putative risk factors.

Childhood and adolescent cancer rates increased during 2001 to 2016 and then declined significantly. This temporal pattern was largely driven by rates of leukemias, lymphomas, CNS tumors, and other epithelial tumors. Changes in cancer classification, screening, and diagnostic technology likely influenced cancer-specific patterns, in addition to potential changes in risk factor prevalence.