4. Trends Over Time
This section provides trends in age-adjusted incidence rates by major cancer site and subsites among children aged 0 to 19 in the National Childhood Cancer Registry (NCCR). Cancer rates often vary from year to year. To determine whether the changes are meaningful changes, the Average Annual Percent Change (AAPC) shows the average of changes over multiple years. The Joinpoint method was used to estimate trends for the most recent 10 years and from 1999-2017.
In the most recent 10 years:
- Incidence is significantly increasing for non-malignant central nervous system neoplasms (AAPC=3.0), epithelial neoplasms and melanomas (AAPC=2.5), hepatic tumors (AAPC=2.3), and malignant germ cell cancer (AAPC=1.5) (Figure 4.1).
- Increasing trends for non-malignant central nervous system neoplasms (APC=3.0) should be interpreted with caution as they were reportable starting in 2004 and likely reflect improvements in case ascertainment (Figure 4.1).
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Figure 4.1: Average Annual Percent Change in the Most Recent 10-years for Major Cancer Sites, 2008-2017#

‡ Increasing trends for non-malignant central nervous system neoplasms should be interpreted with caution as they were reportable starting in 2004 and likely reflect improvements in case ascertainment.
# Cancer site definitions are based on International Classification of Childhood Cancer (ICCC). All cancers are malignant unless otherwise noted.
Download data for Figure 4.1 (XLSX, 12 KB).
Figure 4.2: Annual Incident Rate Trends by Cancer Site, 1999-2017#
I. Leukemias



II. Lymphomas



III. Central Nervous System Neoplasms





IV. Neuroblastoma


V. Retinoblastoma

VI. Renal Tumors


VII. Hepatic Tumors

VIII. Malignant Bone Tumors


IX. Soft Tissue Tumors

X. Germ Cell Tumors





XI. Epithelial Neoplasms and Melanomas

XII. Other and Unspecified Malignant Neoplasms

# Cancer site definitions are based on International Classification of Childhood Cancer (ICCC). All cancers are malignant unless otherwise noted.
* Indicates Annual Percent Change (APC) is statistically significant.
Download data for Figures 4.2 (XLSX, 26 KB)