TABLE 1.
Age-Adjusted Death Rates and Trends for Individuals Younger Than 20 Years With Malignant Cancer in the United States, 2002–2016
| APC and Year Interval for Joinpoints |
|||||||
|---|---|---|---|---|---|---|---|
| Characteristic | % of Total by Characteristic | Count | Rate (95% CI) | AAPC (95% CI) | No. of Joinpoints | Years | APC (95% CI) |
|
| |||||||
| Overall | 100.0 | 30,384 | 24.5 (24.3 to 24.8) | −1.5 (−2.1 to −0.9)a | 1 | 2002–2009 | −2.6 (−3.5 to −1.6)a |
| 2009–2016 | −0.4 (−1.4 to 0.6) | ||||||
| Sex | |||||||
| Male | 56.4 | 17,149 | 27.0 (26.6 to 27.4) | −1.5 (−2.3 to −0.7)a | 1 | 2002–2009 | −3.0 (−4.3 to −1.8)a |
| 2009–2016 | 0.0 (−1.3 to 1.4) | ||||||
| Female | 43.6 | 13,235 | 21.9 (21.5 to 22.3) | −1.5 (−1.9 to −1.0)a | 0 | ||
| Age, y | |||||||
| 0–14 | 67.6 | 20,546 | 22.5 (22.2 to 22.8) | −1.5 (−2.2 to −0.7)a | 1 | 2002–2009 | −2.6 (−3.7 to −1.4)a |
| 2009–2016 | −0.3 (−1.6 to 0.9) | ||||||
| 0–4 | 21.5 | 6547 | 21.9 (21.4 to 22.4) | −1.3 (−1.9 to −0.6)a | 0 | ||
| 5–9 | 23.1 | 7026 | 23.4 (22.8 to 23.9) | −1.6 (−2.4 to −0.9)a | 1 | 2002–2011 | −2.6 (−3.3 to −1.8)a |
| 2011–016 | −0.1 (−1.8 to 2.0) | ||||||
| 10–14 | 22.9 | 6973 | 22.3 (21.7 to 22.8) | −1.4 (−2.1 to −0.6)a | 0 | ||
| 15–19 | 32.4 | 9838 | 30.6 (30.0 to 31.2) | −1.6 (−2.1 to −1.1)a | 0 | ||
| Racial/ethnic groupb | |||||||
| White, non−Hispanic | 56.8 | 17,246 | 24.5 (24.1 to 24.9) | −1.5 (−2.1 to −0.8)a | 1 | 2002–2010 | −2.4 (−3.2 to −1.6)a |
| 2010–016 | −0.2 (−1.5 to 1.2) | ||||||
| Black, non−Hispanic | 15.4 | 4690 | 24.7 (24.0 to 25.4) | −1.4 (−2.0 to −0.7)a | 0 | ||
| Hispanic | 22.2 | 6760 | 25.2 (24.6 to 25.8) | −1.7 (−2.3 to −1.1)a | 0 | ||
| AI/AN, non−Hispanic | 0.8 | 258 | 20.1 (17.8 to 22.8) | −0.9 (−3.1 to 1.3) | 0 | ||
| API, non−Hispanic | 4.5 | 1353 | 21.8 (20.7 to 23.0) | −0.7 (−2.2 to 0.8) | 0 | ||
| US Census region | |||||||
| Northeast | 16.3 | 4950 | 23.5 (22.8 to 24.1) | −1.5 (−2.1 to −0.9)a | 0 | ||
| Midwest | 21.2 | 6447 | 23.8 (23.2 to 24.4) | −1.3 (−2.0 to −0.6)a | 0 | ||
| South | 37.1 | 11,284 | 24.6 (24.1 to 25.0) | −1.2 (−2.3 to −0.2)a | 1 | 2002–2009 | −2.9 (−4.5 to −1.3)a |
| 2009–2016 | 0.5 (−1.2 to 2.3) | ||||||
| West | 25.4 | 7703 | 26.0 (25.4 to 26.6) | −2.2 (−2.8 to −1.5)a | 0 | ||
| Cause of deathc | |||||||
| Liver | 2.5 | 756 | 0.6 (0.6 to 0.7) | −0.3 (−4.3 to 4.0) | 1 | 2002–2014 | −2.9 (−4.6 to −1.1)a |
| 2014–2016 | −17.0 (−14.5 to 60.2) | ||||||
| Bones and joints | 9.0 | 2749 | 2.2 (2.1 to 2.3) | 0.2 (−1.2 to 1.7) | 1 | 2002–2010 | −1.7 (−3.6 to 0.3) |
| 2010–2016 | 2.8 (−0.1 to 5.9) | ||||||
| Soft tissue, including heart | 7.7 | 2352 | 1.9 (1.8 to 2.0) | 0.2 (−0.9 to 1.4) | 0 | ||
| Melanoma of skin | 0.5 | 147 | 0.1 (0.1 to 0.1) | ||||
| Female genital system | 0.6 | 185 | 0.1 (0.1 to 0.2) | ||||
| Male genital system | 0.5 | 144 | 0.1 (0.1 to 0.1) | ||||
| Kidney and renal pelvis | 2.5 | 749 | 0.6 (0.6 to 0.7) | −2.7 (−4.5 to −0.9)a | 0 | ||
| Brain and other nervous system | 26.9 | 8168 | 6.7 (6.5 to 6.8) | −0.6 (−1.9 to 0.8) | 2 | 2002–2009 | −2.1 (−2.9 to −1.2)a |
| 2009–2012 | 3.8 (−3.2 to 11.4) | ||||||
| 2012–2016 | −1.1 (−3.1 to 1.0) | ||||||
| Other endocrine, including thymusd | 8.2 | 2488 | 2.0 (2.0 to 2.1) | −3.4 (−4.8 to −1.9)a | 1 | 2002–2014 | −2.0 (−2.9 to −1.1)a |
| 2014–2016 | −11.3 (−20.2 to −1.4)a | ||||||
| Lymphoma | 4.9 | 1481 | 1.2 (1.1 to 1.2) | −5.1 (−6.1 to −4.0)a | 0 | ||
| Hodgkin lymphoma | 0.8 | 253 | 0.2 (0.2 to 0.2) | ||||
| Non-Hodgkin lymphoma | 4.0 | 1228 | 1.0 (0.9 to 1.0) | −4.6 (−5.7 to −3.6)a | 0 | ||
| Leukemia | 28.5 | 8651 | 7.0 (6.8 to 7.1) | −2.8 (−3.3 to −2.3)a | 0 | ||
| Acute lymphocytic leukemia | 12.4 | 3766 | 3.0 (2.9 to 3.1) | −3.6 (−4.4 to −2.8)a | 0 | ||
| Acute myeloid leukemia | 9.4 | 2847 | 2.3 (2.2 to 2.4) | −2.0 (−3.0 to −1.1)a | 0 | ||
| % of county below poverty levele | |||||||
| 1.81–11.25 | 23.2 | 7118 | 23.3 (22.8 to 23.9) | ||||
| 11.26–15.02 | 22.9 | 7033 | 23.9 (23.4 to 24.5) | ||||
| 15.03–17.80 | 22.6 | 6943 | 24.9 (24.3 to 25.5) | ||||
| 17.81–53.95 | 30.3 | 9290 | 25.8 (25.3 to 26.3) | ||||
| % with <high school education by countye | |||||||
| 1.28–9.11 | 22.3 | 6847 | 22.7 (22.2 to 23.2) | ||||
| 9.12–12.04 | 22.9 | 7017 | 23.4 (22.9 to 24.0) | ||||
| 12.05–15.77 | 25.5 | 7826 | 25.2 (24.7 to 25.8) | ||||
| 15.78–51.48 | 28.3 | 8694 | 26.6 (26.1 to 27.2) | ||||
| Household income by county, median, $e | |||||||
| 18,970–46,950 | 25.3 | 7768 | 24.6 (24.0 to 25.1) | ||||
| 46,960–55,270 | 24.2 | 7412 | 24.2 (23.7 to 24.8) | ||||
| 55,280–64,760 | 25.9 | 7951 | 25.3 (24.8 to 25.9) | ||||
| 64,770–125,670 | 23.6 | 7253 | 24.0 (23.5 to 24.6) | ||||
| Rural/urban status (2010 Census) by county and populatione | |||||||
| Metro areas with ≥1 million | 55.7 | 17,085 | 25.2 (24.8 to 25.6) | ||||
| Metro areas with 250,000 to <1 million | 20.5 | 6302 | 23.7 (23.1 to 24.3) | ||||
| Metro areas with <250,000 | 8.5 | 2620 | 23.4 (22.5 to 24.3) | ||||
| Nonmetropolitan counties | 14.3 | 4377 | 24.2 (23.5 to 24.9) | ||||
Abbreviations: AAPC, average annual percent change; AI/AN, American Indian/Alaska Native; APC, annual percent change; API, Asian/Pacific Islander; CI, confidence interval.
The source for the data is the National Vital Statistics System (National Center for Health Statistics, Centers for Disease Control and Prevention).
Rates are per 1 million persons and are age-adjusted to the 2000 US standard population. Trends were measured with APCs and AAPCs in rates and were considered to increase or decrease if the 95% CI excluded 0 (P < .05); otherwise, trends were considered stable. Trends were calculated with joinpoint regression, which allowed different slopes for as many as 3 periods. AAPCs are presented for all groups; APCs are presented if joinpoints were identified.
Significant AAPC or APC.
Hispanic persons might be of any race; 77 cases of unknown race/ethnicity during 2002–2016 were excluded.
Causes of death were grouped by site codes. Not all causes of death by cancer type are listed here by type.
Included 146 endocrine tumors located in the brain (pituitary, craniopharyneal, or pineal; see https://wonder.cdc.gov/cancer.html).
AAPCs and APCs were not available for county-level variables.