ED-23 * ESTIMATING THE IMPACT OF CHILDHOOD CANCER IN THE UNITED STATES: YEARS OF LIFE LIVED WITH DISEASE AND YEARS OF POTENTIAL LIFE LOST, 2009

Abstract

BACKGROUND: Cancer is one of the leading causes of death among children in the US, and central nervous system (CNS) tumors are the most common type of solid cancer in children <20 years. Incidence rates and overall survival are commonly reported cancer statistics, but they may fail to capture the full impact of childhood cancers. We describe the Years of Potential Life Lost (YPLL) and Years of Life Lived with Disease (YLLD) in children <20 years of age in the US to better understand the public health, economic and personal impact of childhood cancer. METHODS: We examined mortality data due to neoplasm in 2009 among children <20 years old in both the National Vital Statistics System (NVSS) and the Surveillance, Epidemiology, and End Results (SEER) datasets. Histology-specific YPLL and YLLD of CNS tumors, leukemias and lymphomas were measured using SEER data. RESULTS: There were 2,233 deaths and 153,390.4 YPLL due to neoplasm in 2009. CNS tumors were the largest cause of YPLL (31%). Among specific histologies examined, the greatest mean YPLL (mYPLL) was due to atypical teratoid/rhabdoid tumor (ATRT) (78 mYPLL) and high grade glioma (71 mYPLL). The histologies with the highest mean YLLD (mYLLD) were primitive neuroectodermal tumor (4.59 mYLLD), medulloblastoma (3.17 mYLLD) and acute lymphoblastic leukemia (3.09 mYLLD); ATRT had the lowest (0.63 mYLLD). CONCLUSIONS: CNS tumors are the second most common malignancy in children but have the highest cost in YPLL. This study offers the first description of YPLL in childhood tumors defined by histology and proposes a new measure of cancer impact, YLLD. YPLL and YLLD complement the traditional indicators of mortality and help place CNS tumors in the context of other childhood malignancies.