Childhood Cancer Toolkit

The occurrence of cancer during childhood is very rare, representing less than 1 percent of all new cancer diagnoses. Although uncommon, cancer is the second leading cause of death among children exceeded only by accidents. During 2014, approximately 341 cases of cancer and 34 cancer-related deaths occurred among Indiana children ages 0-19. In general childhood cancer trends in Indiana are similar to what is seen throughout the United States. For most cases of childhood cancer the cause is unknown.

The most recent comparable U.S. and Indiana childhood cancer incidence rates show that Indiana rates for ages 0-19 (17.6 cases per 100,000 children) were similar to the national rates (17.9 cases per 100,000 children) during 2008-2012. During the same period, the Indiana and U.S. childhood cancer mortality rates were 2.3 and 2.4 deaths respectively per 100,000 children.

Cancers that are most common in children ages 0-14 are leukemias and brain tumors. The most common cancers among adolescents ages 15-19 are lymphomas and a group of cancer types that include epithelial cancers (cancers that develop from the cellular covering of internal and external body surfaces or related tissues in the skin, hollow viscera and other organs) and melanoma. While cancers occurring in adults are classified by the anatomical site of the primary tumor, cancers in children and younger adolescents are classified by histology (tissue type) into 12 major groups using the International Classification of Childhood Cancers.

Who Gets Childhood Cancer Most Often?

  • White children. During 2010-2014, in Indiana, white children had a significantly higher incidence rate than African-American children (21.1 versus 15.7 cases per 100,000 children). These differences in rates between races are also seen nationally. The reasons for these differences are not known.
  • Children born with certain genetic diseases or familial syndromes. Children with a familial neoplastic syndrome, inherited immunodeficiency, certain genetic syndromes, and chromosomal abnormalities are at a greater risk for developing various types of childhood cancer.
  • Boys born with undescended testes. They are at greater risk for testicular cancer both as a child or adolescent, and later in life as an adult.
  • Additional risk factors include:
    • Radiation exposure, especially prenatally (includes x-rays)
    • Tanning bed or sun exposure increases the risk of melanoma, one of the more common cancers among teenagers
    • Prior chemotherapy with an alkylating agent or epipodophyllotoxin
    • Infection with the Epstein-Barr virus is associated with certain types of lymphoma
    • Insecticide exposure, especially prenatally, is associated with leukemia

Early Detection and Common Signs and Symptoms of Childhood Cancer

Early symptoms of childhood cancer are usually nonspecific. Parents should ensure that children have regular medical checkups and should be aware of any unusual symptoms that persist. Potential cancer-related signs and symptoms include:

  • Unusual mass or swelling
  • Unexplained paleness or loss of energy
  • Sudden tendency to bruise
  • Persistent, localized pain
  • Prolonged, unexplained fever or illness
  • Frequent headaches, often with vomiting
  • Sudden eye or vision changes
  • Excessive, rapid weight loss

Survivorship

Because of major treatment advances in recent decades, more than 80 percent of children with cancer now survive five years or more. Overall, this is a huge increase since the mid-1970s, when the five-year survival rate was less than 60 percent. Still, survival rates vary depending on the type of cancer and other factors. The sooner a cancer is diagnosed and treated, the better. Childhood cancers can be treated by a combination of therapies (surgery, radiation and chemotherapy) chosen based on the type and stage of cancer. Treatment is coordinated by a team of experts, including pediatric oncologists, pediatric nurses, social workers, psychologists, and others. Because these cancers are uncommon, outcomes are more successful when treatment is managed by a children’s cancer center.

Survivors of childhood cancer might experience treatment-related side effects. Information for survivors of childhood cancer is available at www.survivorshipguidelines.org and www.stjude.org.

Resources

  • Childhood Cancer Fact Sheet — Use this fact sheet to educate your partners and communities. The fact sheet provides information and statistics on childhood cancer in Indiana.
  • Sample Press Release for Childhood Cancer Awareness Month (September) — This press release is designed to be customized and sent to local media outlets. County level data is available by contacting the Indiana State Cancer Registry at (317) 233-7424.
  • Sample Social Media Messages — These sample messages can be customized, or used as they are to promote awareness, prevention, and early detection.
  • 2015 Indiana Facts and Figures: Childhood Cancer — Provides current statistics and information on childhood cancer in Indiana in convenient PDF form. This can be linked to documents, websites, presentations, or through social media.
  • Indiana Cancer Control Plan (ICCP) 2010-2014 — Provides a roadmap for cancer control in Indiana. The ICCP includes six focus areas: primary prevention, early detection, treatment, quality of life, data, and advocacy. This can be linked to documents, websites, presentations, or through social media.

Additional online resources: