Measuring Up - A Health Surveillance Update on Canadian Children and Youth

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Cancer Mortality

Despite a dramatic decline in the childhood cancer mortality rate since 1971, cancer still represents the second leading cause of death among Canadian children aged 1-14 years.

Although significant improvements have been achieved in the treatment of childhood cancer over the last few decades, cancer still represents the second leading cause of death (after injuries) among Canadian children aged 1-14 years. Data on cancer deaths are obtained from Canadian mortality statistics, Statistics Canada. The main childhood cancers, such as leukemias, lymphomas and neuroblastomas, are grouped by cell type. Mortality statistics for these cell type groupings have been available since 1982. The childhood cancer mortality rate is the number of cancer deaths per 100,000 children.

In Canada in 1996, there were 189 deaths due to cancer, or 3 deaths per 100,000 children aged 14 years or younger. This represents a dramatic decline from the 430 cancer deaths or 7 deaths per 100,000 children in 1971. This decline, 4% per year since 1970, is largely attributable to major advances in cancer therapy, especially for acute lymphocytic leukemia. Cancer mortality did increase in 1996; however, the relatively small number of deaths from childhood cancer in Canada means that the rates are somewhat unstable, making year-to-year comparisons problematic. Figure 3 depicts cancer mortality rates in children aged 14 years and younger from 1971 until 1996.

Figure 3: Childhood Cancer Mortality Rates, ages 0-14 years, Canada, 1971-1996

Note: Rates are standardized to the age distribution of the 1991 Canadian population.
Source: Cancer Bureau, LCDC, based on Statistics Canada data⁽²⁾

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Leukemias are the most frequent cause of death attributed to cancer in Canadian children, accounting for 36% of childhood cancer deaths from 1985-1996. Tumours of the brain and central nervous system, neuroblastomas and lymphomas account for 26%, 11% and 6% of cancer deaths in children respectively. Figure 4 presents the mortality rates for children aged 0-14 years by cancer type and age group.

Figure 4: Childhood Cancer Mortality Rates, by main cancer type and age group, Canada, 1985-1996

Source: Cancer Bureau, LCDC, based on Statistics Canada data⁽²⁾

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Internationally, declining childhood cancer mortality rates are almost universal, although not uniform.⁽⁴⁾ The speed of the decline has been highly dependent on accessibility to cancer treatment, with the fastest declines noted in developed countries, such as Canada, the United States, Australia and those in Western Europe.

Data limitations
The available data for childhood cancer deaths are very reliable and robust, as there is almost universal ascertainment of the cause of death in children in Canada. Since 1982, mortality statistics grouped by cell type have provided additional valuable childhood cancer data.

Summary
The decline in childhood cancer mortality rates of 4% per year over the last 25 years is a strong indicator of the progress in improving the prognosis of childhood cancer. Canada is one of the countries showing the strongest decline in mortality, likely the result of accessible state-of-the-art medical treatment.

Unless referenced otherwise, childhood cancer mortality statistics are the product of the Cancer Bureau, LCDC⁽²⁾

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