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Progress Against Pediatric Cancer Spurs Concern About Future Problems

MANAGED CARE March 2014. © MediMedia USA
News & Commentary

Progress Against Pediatric Cancer Spurs Concern About Future Problems

The battle against pediatric cancer has made impressive gains in the past 40 years, but new challenges abound and the fight continues, says a study in CA: A Cancer Journal for Clinicians. “Death rates for all childhood and adolescent cancers combined declined steadily by an average of 2.1% per year since 1975, resulting in an overall decline of more than 50%,” say the authors of “Childhood and Adolescent Cancer Statistics, 2014.”

Nonetheless, an estimated 1,960 young people will die from the disease in 2014. Cancer is the second leading cause of death for this group, behind accidents.

Also this year, roughly 15,780 children and adolescents will be diagnosed with cancer.

The study states that “for the most part children who survived five years after diagnosis of their primary tumor had a high probability of subsequent survival.” About 1 in 530 people ages 20–39 is a survivor of childhood cancer. And survivors are vulnerable to a host of problems as they get older.

“For example, the increased use of dexamethasone in contemporary ALL [acute lymphoblastic leukemia] therapy has resulted in higher prevalence of osteonecrosis and spurred research to identify clinical and genetic factors predisposing patients to this complication and its long-term functional limitations,” the study states. It adds that “survivors of HL [Hodgkin’s lymphoma] who are treated with chest irradiation have an increased risk of developing lung cancer, and tobacco use increases this risk 20-fold.”

Researchers cannot pinpoint what causes most childhood cancers. “In contrast to cancers in adults, only a relatively small percentage of all childhood cancers have known preventable causes,” the study states. “Although numerous epidemiologic studies have investigated potential environmental causes of childhood cancers, few strong or consistent associations have been found.”

In addition, not all childhood cancers have seen significant improvement in survival rates. For instance, the median survival time is less than a year for people diagnosed with diffuse intrinsic pontine glioma.

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