The survival of children with cancer has increased considerably in the past 30 years: 83% of children and teenagers are still alive 5 years after their cancer diagnosis, according to figures from the Dutch Cancer Registry. Comprehensive Cancer Center Netherlands shares these figures because of World Child Cancer Day 15 February. This improvement in survival is due to developments in the diagnosis and treatment of childhood cancer, such as adapting treatment to the type and severity of the tumour, better recognition of clinical pictures and new treatments. In 2021, 556 children and teenagers under the age of 18 in the Netherlands were diagnosed with cancer.
Survival increases and mortality decreases
The survival of children with cancer has increased considerably in recent decades. In the 1990s, 73% were still alive after 5 years, twenty years later that had risen to 83%. Survival is highest with Hodgkin lymphoma, retinoblastoma and germ cell tumours: over 95% of children with one of these conditions are still alive after 5 years. The prognosis is worst with certain types of brain cancer, neuroblastoma, and a specific form of bone cancer, osteosarcoma. Less than 70% of these children are still alive 5 years after diagnosis.
Dr.ir. Henrike Karim-Kos, child cancer researcher at IKNL and research group leader at the Princess Máxima Center for Pediatric Oncology: ‘It is encouraging to see that survival of children with cancer is on the rise, but there is still a long way to go.’ Despite improved survival, cancer is still one of the leading causes of death in children. In 2021, 60 children under the age of 20 will die of cancer. Of all cancers, most children die from leukemia or a brain tumour.
Incidence of childhood cancer stable
The incidence (number of new cases) of cancer in children and teenagers has been stable in recent decades, with boys being affected more often than girls (in 2021: 297 boys and 259 girls). Leukemia (159 new diagnoses in 2021), brain tumors (123) and lymphomas (89) are the most common forms of childhood cancer in the Netherlands. Other childhood cancers include neuroblastoma (cancer in the precursor cells of the nervous system), retinoblastoma (cancer of the retina of the eye), nephroblastoma (kidney cancer), hepatoblastoma (cancer of the liver), sarcomas, and germ cell tumors (cancer of the germ cells) .
Cancer in children is often different from cancer in adults. Not only does a large proportion of childhood cancers only occur in children, the treatment and cure rates are also different from those in adults. For example, retinoblastomas, neuroblastomas, and nephroblastomas only occur in children. These are tumors that originated in progenitor cells – these types of cells are hardly present in adults, if at all.
Different types of childhood cancer by age
More than a third of all cases of childhood cancer are diagnosed in children under the age of 5 (196 of the 556 new diagnoses in 2021). Leukaemia, brain tumours, neuroblastoma and nephroblastoma are the most common cancers in this youngest age group. Leukemia and brain tumors are also the most common forms in the other age groups. Lymphomas and epithelial tumors increase in incidence with age. Non-Hodgkin lymphoma also occurs at a younger age, while Hodgkin lymphoma is more often seen in older children and teenagers.
Care for children with cancer
There are agreements on the diagnosis and treatment of childhood cancer. This has been centralized since 2018 and takes place at the Princess Máxima Center for Pediatric Oncology in Utrecht for children and teenagers up to the age of 18. The Princess Máxima Center works in close coordination with a number of shared care centers across the Netherlands, where care can be designed closer to home if possible.
