Pediatric cancer survival in the United States from 2001 to 2021

Approximately 15,000 United States (US) children and adolescents, 0-14 and 15-19 years old, respectively, are diagnosed with cancer annually. Although overall survival now exceeds 80%, cancer remains the second leading cause of death in this population, and improvements have not been uniform across subgroups.

Five- and 10-year relative survival (RS) for cancer cases diagnosed during 2001-2021 among individuals <20 years old at diagnosis were calculated using the National Program of Cancer Registries database, covering 87.4% of the US population. Results were stratified by age, sex, race and ethnicity, US Census region, economic status, cancer type, stage, and diagnosis year. All-cause survival was calculated using the Kaplan-Meier method with log-rank testing.

Among 272,279 pediatric cancers diagnosed from 2001 to 2021, 5-year RS was 84.7%, and 10-year RS was 82.3%. Five-year RS increased from 83.0% in 2001-2011 to 86.8% in 2012-2021. Ten-year RS was higher for females than males. By age, adolescents 15-19 years old had the highest RS, whereas infants had the lowest. Non-Hispanic Black patients had the lowest 5- and 10-year RS (79.2% and 76.3%, respectively) compared with non-Hispanic White patients (86.3% and 84.0%). RS was highest for patients in the top 25% of counties by economic status and in the Northeastern US Census region. Overall, all-cause 10-year survival was 81.7% and differed by sex, age, race and ethnicity, stage, and cancer subtypes.

Pediatric cancer survival has continued to improve. However, differences persist by age, sex, race and ethnicity, economic status, geography, and cancer type.