Children's cancers incidence statistics

Cases

New cases of children's cancer, 2012-2014, UK

 

Proportion of all cases

Percentage children's cancer is of total cancer cases, 2012-2014, UK

 

Age

Peak rate of children's cancer cases, 2012-2014, UK

 

Trend over time

Change in children's cancers incidence rates since the early 1990s, UK

In 2012-2014, there was an average of 1,756 new cases of cancer in children per year in the UK: 947 (54%) in boys and 809 (46%) in girls, giving a male:female ratio of around 12:10.[1-4] The crude incidence rate shows that there are 164 new cancer cases for every million boys aged 0-14 in the UK, and 147 for every million girls aged 0-14.[1-4]

The world age-standardised Open a glossary item (AS) incidence rates do not differ significantly between the constituent countries of the UK for either sex.[1-4]

All Children's Cancers, Average Number of New Cases per Year, Crude and World Age-Standardised (AS) Incidence Rates per Million Population, Ages 0-14, UK, 2012-2014

England Wales Scotland Northern Ireland United Kingdom
Boys Cases 802 48 67 30 947
Crude Rate 163.5 179.1 154.5 161.5 163.5
W-AS Rate 165.9 183.2 158.8 163.8 166.1
W-AS Rate - 95% LCL 159.3 153.2 136.9 129.7 159.9
W-AS Rate - 95% UCL 172.5 213.2 180.7 197.8 172.2
Girls Cases 684 39 60 26 809
Crude Rate 146.4 155.6 143.2 147.0 146.6
W-AS Rate 148.6 156.8 145.5 148.2 148.8
W-AS Rate - 95% LCL 142.2 128.5 124.2 115.1 142.9
W-AS Rate - 95% UCL 155.1 185.1 166.8 181.4 154.7
Children Cases 1,486 87 127 55 1,756
Crude Rate 155.2 167.7 149.0 154.4 155.2
W-AS Rate 157.5 170.3 152.3 156.2 157.6
W-AS Rate - 95% LCL 152.8 149.7 137.0 132.4 153.4
W-AS Rate - 95% UCL 162.1 191.0 167.6 179.9 161.9

95% LCL and 95% UCL are the 95% lower and upper confidence limits Open a glossary item around the W-AS Rate
 
All children’s cancers for England, Wales and Scotland includes all malignant tumours (ICD-10 codes: C00-C97) and all benign/uncertain or unknown behaviour brain, other central nervous system and intracranial tumours (ICD-10 codes: D32-D33, D35.2-D35.4, D42-D43 and D44.3-D44.5). Northern Ireland data includes all the above codes except D33.7, D33.9, D43.7 and D43.9.
 
Cases for boys and girls may not sum to the total for children due to rounding.

References

  1. Data were provided by the Office for National Statistics on request, June 2016. Similar data can be found here: http://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/cancerregistrationstatisticsengland/previousReleases.
  2. Data were provided by ISD Scotland on request, May 2016. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/.
  3. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit, Health Intelligence Division, Public Health Wales on request, June 2016. Similar data can be found here: http://www.wcisu.wales.nhs.uk.
  4. Data were provided by the Northern Ireland Cancer Registry on request, May 2016. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/.

About this data

Data is for: UK, 2012-2014, ICD-10 C00-C97 plus D32-D33, D35.2-D35.4, D42-D43, D44.3-D44.5 (excluding D33.7, D33.9, D43.7 and D43.9 in Northern Ireland).

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The highest incidence rates for all children's cancers combined are in the under-fives for both sexes, with almost half (48%) of all cases in children being diagnosed in this age group (UK, 2012-2014).[1-4] This pattern varies greatly by cancer type.[5]

Childhood cancer usually has no known cause. For most cancer types incidence increases with age, which largely reflects cell DNA damage accumulating over time. Damage can result from biological processes or from exposure to risk factors. A drop or plateau in incidence in the oldest age groups often indicates reduced diagnostic activity perhaps due to general ill health.

References

  1. Data were provided by the Office for National Statistics on request, June 2016. Similar data can be found here: http://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/cancerregistrationstatisticsengland/previousReleases
  2. Data were provided by ISD Scotland on request, May 2016. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/ 
  3. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit, Health Intelligence Division, Public Health Wales on request, June 2016. Similar data can be found here: http://www.wcisu.wales.nhs.uk
  4. Data were provided by the Northern Ireland Cancer Registry on request, May 2016. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/
  5. Data were provided by Charles Stiller/Childhood Cancer Research Group on request, 1996-2005.
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Incidence rates for cancer in children have increased by 11% in the UK since the early 1990s.[1-3] This includes a larger overall increase for girls than for boys. Children's cancers incidence rates increased by 15% (persons) in Great Britain between 1979-1981 and 1991-1993.[1-3]

For boys aged 0-14, World age-standardised (AS) incidence rates increased by 9% between 1993-1995 and 2012-2014. For girls aged 0-14, rates increased by 15% between 1993-1995 and 2012-2014.

Over the last decade in the UK (between 2003-2005 and 2012-2014), World AS incidence rates for cancer in children have remained stable for boys and girls combined and separately.[1-4]

All Children's Cancers, World Age-Standardised Incidence Rates, Ages 0-14, UK, 1993-2014​

All children’s cancers for England, Wales and Scotland includes all malignant tumours excluding non-melanoma skin cancer (ICD-10 codes: C00-C97 excl C44) and all benign/uncertain or unknown behaviour brain, other central nervous system and intracranial tumours (ICD-10 codes: D32-D33, D35.2-D35.4, D42-D43 and D44.3-D44.5). Northern Ireland data includes all the above codes except D33.7, D33.9, D43.7 and D43.9

These trends include benign/uncertain or unknown behaviour brain, other central nervous system and intracranial tumours because they account for a relatively high proportion of cases in this age group. However trends for these tumours are unreliable pre-2000s, and largely reflect improved data collection rather than true increased incidence. Percentage increases since the late 1970s and early 1990s are very slightly smaller if these tumours are excluded.

References

  1. Data were provided by the Office for National Statistics on request, June 2016. Similar data can be found here: http://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/cancerregistrationstatisticsengland/previousReleases
  2. Data were provided by ISD Scotland on request, May 2016. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/
  3. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit, Health Intelligence Division, Public Health Wales on request, June 2016. Similar data can be found here: http://www.wcisu.wales.nhs.uk
  4. Data were provided by the Northern Ireland Cancer Registry on request, May 2016. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/

About this data

Data is for UK, 1993-2014, All children's cancers ICD-10 codes (C00-C97) and all benign/uncertain or unknown behaviour brain, other central nervous system and intracranial tumours (ICD-10 codes: D32-D33, D35.2-D35.4, D42-D43 and D44.3-D44.5)

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Childhood cancers are further classified into cancer type using the International Classification of Childhood Cancer (ICCC), which takes the tumour's anatomical site and morphology into account. The ICCC divides childhood cancers in 12 cancer types (called diagnostic groups), with further subgroups and divisions.[1]

The three most common cancer types in children are leukaemia, brain, other central nervous (CNS) and intracranial tumours, and lymphomas.[2] Leukaemia is the most common childhood cancer, accounting for nearly a third of all cases (31% and 29% in boys and girls, respectively) in Great Britain between 2006 and 2008.[2]

Childhood Cancers by Cancer Type, Average Number of New Cases per Year, Ages 0-14, Great Britain, 2006-2008

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Leukaemia forms the most commonly diagnosed cancer in children, accounting for around a third (30%) of all cases.[1]

Acute lymphoblastic leukaemia (ALL) is the most common type of children's leukaemia by far. ALL accounts for around four-fifths (78%) of all leukaemias diagnosed in children,[2] and as such largely determines the age and sex pattern for children's leukaemia overall.

Incidence peaks in boys and girls at the ages of three and two years, respectively, and decreases with age thereafter.[2] The incidence of ALL is much lower in adults.

The next most common leukaemia diagnosed in children is acute myeloid leukaemia (AML). AML accounts for 15% of children's leukaemia; incidence rates are highest in infants (under one-year-olds) and show little variation with age from three onward.[2]

Leukaemia, Average Annual Age-Specific Incidence Rates per Million Population, Great Britain, 1996–2005

References

  1. 2006-2008. National Registry of Childhood Tumours/Childhood Cancer Research Group.
  2. Data were provided by Charles Stiller/Childhood Cancer Research Group on request, 1996-2005.
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Brain, other CNS and intracranial tumours form the second most common group of cancers in children, accounting for a more than a quarter (26%) of all childhood cancers.[1]

The largest subgroup is astrocytoma Open a glossary item and these constitute over two-fifths (43%) of all brain, other CNS and intracranial tumours in children.[2] Astrocytoma is diagnosed throughout childhood and there is no strong pattern by either sex or age. Around three-quarters (76%) of astrocytomas are diagnosed as low grade Open a glossary item and 15% as high grade Open a glossary item.[3]

The second most frequent subgroup is the intracranial and intraspinal embryonal Open a glossary item tumours, which account for around a fifth (19%) of all childhood brain, other CNS and intracranial tumours.[2] Most of this subgroup are primitive neuroectodermal tumours (PNETs), with nearly three-quarters (73%) being medulloblastoma Open a glossary item.[3] PNETs occur most frequently in younger children and incidence decreases with age.[2]

Ten per cent of childhood brain, other CNS and intracranial tumours are defined as ependymoma Open a glossary item and choroid plexus tumours; incidence is highest in one-year-olds in this subgroup.[2]

Brain, other CNS and Intracranial Tumours, Average Annual Age-Specific Incidence Rates per Million Population, Great Britain, 1996–2005

References

  1. National Registry of Childhood Tumours/Childhood Cancer Research Group, http://www.ccrg.ox.ac.uk/datasets/registrations.shtml 
  2. Data were provided by Charles Stiller/Childhood Cancer Research Group on request.
  3. Stiller CA. Childhood cancer in Britain: Incidence, survival, mortality. Oxford: Oxford University Press; 2007.
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Lymphomas account for 11% of all cancers diagnosed in children and more than twice as many cases are diagnosed in boys as in girls.[1] Lymphomas are rare before the age of two and incidence increases with age thereafter such that lymphomas account for nearly a fifth (19%) of all childhood cancers diagnosed in 10-14 year-olds.[1]

There are two main types of lymphoma: Hodgkin lymphoma Open a glossary item (also known as Hodgkin’s disease) and non-Hodgkin lymphoma (NHL). Hodgkin lymphoma accounts for around 45% of all lymphomas diagnosed in children.[2] Incidence increases steadily after the age of two until the last few years of childhood, where there is a much sharper increase such that more than two-thirds (71%) of all childhood Hodgkin lymphomas are diagnosed in 10–14 year-olds.[2]

NHL (including Burkitt lymphoma) accounts for more than half (53%) of all lymphomas in children.[2] Incidence of NHL increases sharply in the first few years of childhood and subsequently increases more gradually with age.[2]

Lymphomas, Average Annual Age-Specific Incidence Rates per Million Population, Great Britain, 1996–2005

References

  1. National Registry of Childhood Tumours/Childhood Cancer Research Group. http://www.ccrg.ox.ac.uk/datasets/registrations.shtml
  2. Data were provided by Charles Stiller/Childhood Cancer Research Group on request, 1996-2005.
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The wide-ranging group of soft tissue sarcoma accounts for 6% of all childhood cancers.[1] Incidence is similar in both sexes in early and late childhood, but is markedly higher in boys between the ages of three and eight.[2]

Around a half (51%) of all soft tissue sarcomas are rhabdomyosarcoma, which can occur in almost all parts of the body.[2] The incidence of rhabdomyosarcoma is highest in three-year-olds.[2]

Ewing and Askin tumours of soft tissue and peripheral primitive neuroectodermal tumours (pPNETs) of soft tissue collectively account for 15% of all soft tissue sarcomas.[3] These tumours mainly occur in the trunk (62%), with the remainder being evenly divided between the head and neck and the limbs.[3] Incidence remains fairly constant throughout most of childhood, with just a small increase in the last few years.[2]

Bone and Soft Tissue Sarcomas, Average Annual Age-Specific Incidence Rates per Million Population, Great Britain, 1996–2005

References

  1. Data were provided by National Registry of Childhood Tumours/Childhood Cancer Research Group on request, 2006-2008. Similar data can be found here: http://www.ccrg.ox.ac.uk/datasets/registrations.shtml
  2. Data were provided by Charles Stiller/Childhood Cancer Research Group on request, 1996-2005.
  3. Stiller CA. Childhood cancer in Britain: Incidence, survival, mortality. Oxford: Oxford University Press; 2007.
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Bone sarcoma accounts for 4% of all childhood cancers.[1] Incidence rates are very similar in both sexes and increase steadily with age; overall, bone sarcoma accounts for 9% of all cancers diagnosed in 10-14 year-olds.[1]

The most common types of bone sarcoma are osteosarcoma Open a glossary item (accounting for 53% of cases) and Ewing tumour Open a glossary item and related bone sarcomas (42% of cases).[2]

Osteosarcoma is extremely rare under the age of three; incidence increases with age thereafter such that over two-thirds (69%) of osteosarcomas are diagnosed in 10-14 year-olds.[2] The vast majority of osteosarcomas are diagnosed in the long bones of the legs (84%) and arms (12%).[3]

Ewing tumour and related bone sarcomas are mainly peripheral primitive neuroectodermal tumours (pPNETs) of the bone. Tumours can occur at a variety of sites, the most common being the long bones of the legs (38%) and the pelvis (23%).[3] Incidence of these tumours peaks in the last few years of childhood, with a male excess in 10-14 year-olds.[2]

References

  1. National Registry of Childhood Tumours/Childhood Cancer Research Group. http://www.ccrg.ox.ac.uk/datasets/registrations.shtml accessed 2006-2008
  2. Data were provided by Charles Stiller/Childhood Cancer Research Group on request,1996-2005
  3. Stiller CA. Childhood cancer in Britain: Incidence, survival, mortality. Oxford: Oxford University Press; 2007.
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Embryonal tumours are characterised by the proliferation of tissue that is normally seen only in the developing embryo. There are four principal types – neuroblastoma Open a glossary item in the sympathetic nervous system, retinoblastoma Open a glossary item in the eye, nephroblastoma (also known as Wilms' tumour ) in the kidney and hepatoblastoma in the liver. Other embryonal tumours include medulloblastoma Open a glossary item in the brain and embryonal rhabdomyosarcoma Open a glossary item in soft tissue.

Embryonal tumours are generally very rare after childhood, and occur most commonly in the first few years of life.[1] Several types of embryonal tumour have a peak in incidence in the first year of life and some types are occasionally found to be present at birth.

Embryonal Tumours, Average Annual Age-Specific Incidence Rates per Million Population, Great Britain, 1996–2005

References

  1. Data were provided by Charles Stiller/Childhood Cancer Research Group on request, 1996-2005.
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Renal tumours account for 5% of all childhood cancers. Nine out of ten cases (90%) are nephroblastoma (also known as Wilms' tumour).[1,2] Nephroblastoma is an embryonal tumour, but it is somewhat different to the other principal types in that incidence rates have a slightly later peak in one- to three-year-olds.[1] The majority (90%) of nephroblastomas occur in one kidney only.[2]

References

  1. Data were provided by Charles Stiller/Childhood Cancer Research Group on request, 1996-2005.
  2. Stiller CA. Childhood cancer in Britain: Incidence, survival, mortality. Oxford: Oxford University Press; 2007.
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Tumours of the sympathetic nervous system (SNS) account for 5% of all childhood cancers,[1] and nearly all tumours of the SNS are neuroblastoma (including ganglioneuroblastoma).[2]

Neuroblastoma is one of the principal embryonal tumours and is the most frequently occurring solid tumour in infants under the age of one, accounting for around a fifth (22%) of all cancers diagnosed at this age.[2] The incidence of neuroblastoma is rare after the age of five.[2] Almost half (46%) of neuroblastomas develop in the adrenal gland; other abdominal primary sites account for just over a quarter (26%) of cases, and thoracic sites account for 13%.[3]

References

  1. National Registry of Childhood Tumours/Childhood Cancer Research Group. http://www.ccrg.ox.ac.uk/datasets/registrations.shtml acessed 2006-2008.
  2.  Data were provided by Charles Stiller/Childhood Cancer Research Group on request, 1996-2005
  3. Stiller CA. Childhood cancer in Britain: Incidence, survival, mortality. Oxford: Oxford University Press; 2007.
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Retinoblastoma is another principal embryonal tumour and accounts for 3% of all cancers diagnosed in children.[1] Around two-fifths (40%) of cases are diagnosed in the first year of life and incidence rates drop to a very low rate after five years of age.[2]

Around two-thirds (63%) of retinoblastomas are diagnosed in one eye only.[3]

References

  1. National Registry of Childhood Tumours/Childhood Cancer Research Group. http://www.ccrg.ox.ac.uk/datasets/registrations.shtml. Accessed 2006-2008
  2. Data were provided by Charles Stiller/Childhood Cancer Research Group on request, 1996-2005.
  3. Stiller CA. Childhood cancer in Britain: Incidence, survival, mortality. Oxford: Oxford University Press; 2007.
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Tumours of the liver are quite rare in childhood, with around two children in every million being diagnosed with the condition every year (accounting for 1% of all childhood cancers).[1] This group is broadly divided into hepatoblastoma and hepatic carcinoma, which account for around four-fifths (81%) and one-fifth (18%) of cases, respectively.[2,3]

Hepatoblastoma is the rarest of the four principal embryonal tumours, and is most likely to be diagnosed in children under two years of age.[2]

References

  1. National Registry of Childhood Tumours/Childhood Cancer Research Group. http://www.ccrg.ox.ac.uk/datasets/registrations.shtml Accessed 2006-2008.
  2. Data were provided by Charles Stiller/Childhood Cancer Research Group on request, 1996-2005
  3. Stiller CA. Childhood cancer in Britain: Incidence, survival, mortality. Oxford: Oxford University Press; 2007.
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Carcinomas Open a glossary item and malignant melanoma Open a glossary item account for 4% of all childhood cancers.[1] The group consists of carcinomas other than those of the kidney, liver and gonads that have already been mentioned, and malignant melanoma. Malignant melanoma accounts for around a quarter (24%) of the group, and carcinomas of the thyroid and skin account for 22% and 20%, respectively.[2]

References

  1. National Registry of Childhood Tumours/Childhood Cancer Research Group. http://www.ccrg.ox.ac.uk/datasets/registrations.shtml. Accessed 2006-2008.
  2. Data were provided by Charles Stiller/Childhood Cancer Research Group on request, 1996-2005.
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Germ cell and gonadal tumours Open a glossary item account for 4% of all childhood cancers.[1] The pattern by age and sex varies greatly by tumour type.[2]

Germ Cell and Gonadal Tumours, Average Annual Age-Specific Incidence Rates per Million Population, Great Britain, 1996–2005

Malignant gonadal germ cell tumours account for 39% of this group; male gonadal germ cell tumours are most likely to be diagnosed in children less than two years old, with incidence rising again in teenagers, whereas incidence of female gonadal tumours increases with age.[2] Tumours originating within the brain and spine account for around a third (33%) of all gonadal and germ cell tumours, and are more common in older children.[2] Other tumours in this group include extracranial and extragonadal germ cell tumours.

References

  1. National Registry of Childhood Tumours/Childhood Cancer Research Group. http://www.ccrg.ox.ac.uk/datasets/registrations.shtml. Accessed 2006-2008.
  2. Data were provided by Charles Stiller/Childhood Cancer Research Group on request, 1996-2005.
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At the end of 2005, it was estimated that around 26,000 people in Great Britain were long-term childhood cancer survivors, alive who had survived five years or longer after being diagnosed with childhood cancer.[1] It is estimated that by the end of 2012 there will be at least 33,000 people in the UK who are alive having previously been diagnosed with a childhood cancer and who survived their cancer for at least five years.[2] These figures are based on data going back to before the 1960s and are different to prevalence figures reported elsewhere on the site.

References

  1. Stiller CA. Childhood cancer in Britain: Incidence, survival, mortality. Oxford: Oxford University Press; 2007.
  2. Data were provided by Charles Stiller/Childhood Cancer Research Group on request, October 2012.

About this data

Data is for: All UK patients who had been diagnosed with cancer in childhood before December 31st, ICD-10 C00-C97 plus D32-D33, D35.2-D35.4, D42-D43, D44.3-D44.5

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Two large publications by the International Agency for Research on Cancer (IARC) in the 1980s and 1990s showed substantial variations in childhood cancer incidence between different regions of the world.[1,2] For all childhood cancers diagnosed in the period 1980-1994, the World age-standardised incidence rates were typically in the range 70-160 cases per million children.[3] The UK incidence rate was at the lower end of the range observed in westernised countries, and Oceania and the white populations of North America were at the highest. More recent analyses of childhood cancer incidence in Australia and the US have shown continued high rates in comparison to the rest of the world.[4,5]

In Europe, the Automated Childhood Cancer Information System (ACCIS) has enabled a detailed analysis of childhood cancer incidence across the continent.[6] In the period 1988-1997, childhood cancer incidence rates were highest in Northern Europe and lowest in the British Isles/UK. Of the 19 countries studied, incidence rates were lowest in Turkey, Hungary and the UK and highest in Finland, Italy and Denmark. All of the diagnostic groups showed significant differences across Europe; brain and CNS tumours had the greatest variation in incidence, though differences in registration practice for non-malignant brain and CNS tumours could have accounted for some of the variation.[6]

Childhood Cancers including Non-Malignant Brain and Central Nervous System Tumours, Age-Standardised (World) Annual Incidence Rates per Million Population, Europe, 1988-1997

Increases in childhood cancer incidence since the 1960s and 1970s have been reported in Europe and the rest of the world.[4,5,7,8] Results from the ACCIS project have shown slightly higher increases in incidence of childhood cancer in Europe as a whole than in Great Britain.[7,8] Over a twenty year time period, the World AS incidence rate for Europe significantly increased by an average of 1.1% per year, from 120 per million children in 1978-1982 to 141 per million in 1993-1997.[7]

This varied across Europe, ranging from an average annual increase of 1.0% per year in Northern Europe to 1.4% per year in Eastern Europe. Slightly lower average annual increases of 0.6% per year were observed in the US over a similar time period,[9] and a more recent US study reported a slowing down of this increase to a non-significant average annual increase of just 0.4% per year since the early 1990s.[5] Recent findings from an Australian study are also consistent with a plateau in childhood cancer incidence rates from the mid-1990s onwards.[4] While some of the worldwide increases are likely to be due to real changes in risk, improvements in the efficiency of systems for the diagnosis and registration of childhood cancers since the 1960s and 1970s will also have played a part.[10-12]

References

  1. International Agency for Research on Cancer (IARC) and the International Association of Cancer Registries (IACR). International incidence of childhood cancer. IARC Sci Publ 1988:1-401.
  2. IARC and IACR. International Incidence of Childhood Cancer, Vol. II. IARC Sci Publ 1998:1-391.
  3. Stiller CA. Epidemiology and genetics of childhood cancer. Oncogene 2004;23:6429-44.
  4. Baade PD, Youlden DR, Valery PC, et al. Trends in incidence of childhood cancer in Australia, 1983-2006. Br J Cancer 2010;102:620-6.
  5. Linabery AM, Ross JA. Trends in childhood cancer incidence in the U.S. (1992-2004). Cancer 2008;112:416-32.
  6. Stiller CA, Marcos-Gragera R, Ardanaz E, et al. Geographical patterns of childhood cancer incidence in Europe, 1988-1997. Report from the Automated Childhood Cancer Information System project. Eur J Cancer 2006;42:1952-60.
  7. Kaatsch P, Steliarova-Foucher E, Crocetti E, et al. Time trends of cancer incidence in European children (1978-1997): report from the Automated Childhood Cancer Information System project. Eur J Cancer 2006;42:1961-71.
  8. Steliarova-Foucher E, Stiller C, Kaatsch P, et al. Geographical patterns and time trends of cancer incidence and survival among children and adolescents in Europe since the 1970s (the ACCISproject): an epidemiological study. Lancet 2004;364:2097-105.
  9. Ward EM, Thun MJ, Hannan LM, et al. Interpreting cancer trends. Ann N Y Acad Sci 2006;1076:29-53.
  10. Stiller CA. Childhood cancer in Britain: Incidence, survival, mortality. Oxford: Oxford University Press; 2007.
  11. Adamson P, Law G, Roman E. Assessment of trends in childhood cancer incidence. Lancet 2005;365:753.
  12. Steliarova-Foucher E, Stiller C, Kaatsch P, et al. Trends in childhood cancer incidence in Europe, 1970-99. Lancet 2005;365:2088.
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