Mortality Rates in Childhood Cancer Higher Than Previously Thought

Early death among young children (<1 year of age) with cancer is higher than previous estimates according to a study published in the Journal of Clinical Oncology. Using the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database, researchers collected data from children (0-19 years) diagnosed with any form of cancer between 1992 and 2011. Early death was considered survival for less than one month after diagnosis (the shortest time interval available through SEER). The authors identified 36,337 cases of pediatric cancer; 555 of these patients experienced early death, accounting for 1.5 percent of mortality.

This is higher than estimates from large clinical trials, the authors noted. As seen in the FIGURE, when comparing the rates of early death seen in the SEER database to rates of early death reported in clinical trial data, early death was higher in all included cancer subtypes:

  • acute myeloid leukemia: 1.6% vs. 6.2%
  • non-infant acute lymphocytic leukemia (ALL): 0.7% vs. 1.3%
  • infant ALL: 2.0% vs. 5.4%
  • hepatoblastoma: 1.4% vs. 3.8%
  • Wilms tumor: 0.04 vs. 0.5%

Notably, children with hematologic malignancies had a higher risk of early death (odds ratio = 2.23; 95% CI 1.80-2.76; p value not reported) than those with solid tumors.

The authors concluded that early death is underreported and requires future investigation to better assess treatment options and risk factors such as “age younger than one year, specific diagnoses, minority race and ethnicity, and disadvantaged socioeconomic status.” Limitations to the SEER data include time from diagnosis until death in the first month and availability of the underlying cause of death.

Source: Green A, Furutani E, Ribeiro K, et al. Death within 1 month of diagnosis in childhood cancer: an analysis of risk factors and scope of the problem. J Clin Oncol. 2017 March 6. [Epub ahead of print]