Children's and Young People's Cancer: Where a Child Lives Shapes Their Chances

Cancer in children and young people is rare, and in countries with well-resourced care most children diagnosed in recent years are alive five years later. The CONCORD-4 registry study, covering 68 countries and territories, found five-year survival above 80% in most participating high-income countries for children diagnosed in 2015 to 2019, but 50% to 60% in the lower-middle-income countries that took part, and modelling suggests that where few registries exist, survival is far lower even among the children who are diagnosed, and many children are never diagnosed at all.^[1][2][3]

Behind every figure here is a family: a parent hearing words they never expected to hear about their child, brothers and sisters whose lives change too, a teenager facing treatment just as school, friendships and independence matter most. This article sets out what the evidence shows about how often cancer occurs in children and young people, how survival differs between countries, what life can look like years after treatment, and where teenagers and young adults fall between services. It keeps each figure attached to its source, its age band and its period, because these numbers describe groups of people, never what will happen to one child.

Cancer in children and young people is rare, and different from cancer in adults

Age bands matter in this field, and sources use different ones. In this article, children means ages 0 to 14 and adolescents ages 15 to 19. Teenagers and young adults (TYA) means ages 15 to 24, as used by England's National Disease Registration Service; European studies of adolescents and young adults (AYA) use a wider band, 15 to 39. Some services and charities use other bands, such as 13 to 24, so check the band before comparing figures.

The most detailed international picture of how often cancer occurs comes from the third volume of the International Incidence of Childhood Cancer study (IICC-3), led by the International Agency for Research on Cancer. It pooled 385,509 cancers diagnosed before age 20 in 2001 to 2010, from 153 population-based registries in 62 countries, departments and territories.^[5] The age-standardised incidence rate in children aged 0 to 14 was 140.6 per million person-years, up from 124.0 in the 1980s. Leukaemia was the most common cancer in children, followed by tumours of the brain and central nervous system, then lymphomas. In adolescents aged 15 to 19 the age-specific rate was higher, 185.3 per million, and the pattern different: lymphomas were most common, followed by the group of epithelial tumours (carcinomas) and melanoma.^[5]

Put into numbers of people: in the United States, the National Cancer Institute estimated that in 2024 about 9,620 children aged 0 to 14 and 5,290 adolescents aged 15 to 19 would be diagnosed with cancer.^[6] In the UK, an average of 1,645 children aged 0 to 14 and 2,110 teenagers and young adults aged 15 to 24 were diagnosed each year in 1997 to 2016.^[7] Among children aged 0 to 14, recorded rates were lowest, under 100 per million, in sub-Saharan Africa, in India and among Native American children in the USA, and highest, above 150, in some populations of North America, Europe and Oceania.^[5] As the next section shows, part of that gap is likely to reflect children who are never diagnosed or recorded.

Many children's cancers are never diagnosed, mostly in lower-income countries

Registries can only count the children who reach a diagnosis. To estimate how many do not, researchers built a simulation model of childhood cancer in 200 countries and territories, calibrated to registry data, and published it in The Lancet Oncology in 2019. It estimated about 397,000 new childhood cancers worldwide in 2015, of which about 224,000 were diagnosed: about 43% were not.^[3] The undiagnosed share was estimated at about 3% in western Europe and North America, about 49% in south Asia and about 57% in western Africa. The authors concluded that "Childhood cancer is substantially underdiagnosed, especially in south Asia and sub-Saharan Africa," and projected about 6.7 million childhood cancers in 2015 to 2030, of which about 2.9 million would be missed if health systems continued to perform as they did.^[3]

These are modelled estimates, not counts, and they carry uncertainty. But they point the same way as other evidence. The Global Burden of Disease study estimated that in 2017 cancer in people aged 0 to 19 led to 11.5 million disability-adjusted life-years (DALYs, a measure combining years of life lost and years lived with illness), and that 82.2% of them were in countries in the low, low-middle and middle bands of its socio-demographic index. It ranked childhood cancer ninth among causes of ill health and early death in children worldwide.^[8] In other words, the children whose cancer is least likely to be found, and least likely to be counted, are concentrated where most of the world's children live.

Survival is above 80% in most high-income countries, and much lower where care is out of reach

The strongest evidence on survival comes from the global CONCORD programme. Its fourth round, published in The Lancet in March 2026, analysed individual records for 613,021 children diagnosed with cancer in 1990 to 2019, from 307 population-based registries in 68 countries and territories. It combined five-year net survival for all cancers in children aged 0 to 14, standardised by age, sex and cancer type, into a single Cancer Survival Index. The index rose in most countries over the three decades. For children diagnosed in 2015 to 2019, it was above 80% in most participating high-income countries, 60% to 80% in most upper-middle-income countries, and 50% to 60% in the five lower-middle-income countries that took part.^[1]

That is real progress. It also describes only countries with population-based registries able to take part, and the published results cover high-income, upper-middle-income and five lower-middle-income countries. For the rest of the world, the best available figures are modelled. The 2019 simulation study estimated global five-year net survival for children whose cancer is diagnosed at 37.4% (95% uncertainty interval 34.7% to 39.8%), ranging by region from 8.1% in eastern Africa to 83.0% in North America; the figure covers diagnosed cases only, so it does not count the children, described above, whose cancer is never found.^[2] The World Health Organization's fact sheet, dated March 2026, summarises the gap in its own words: in high-income countries "more than 80% of children with cancer are cured", while in most low- and middle-income countries "less than 30% are cured".^[4] The registry, modelled and WHO figures use different methods and periods, so they are not directly comparable, but each shows the same divide.

These gaps lie in health systems, not in children or their families. Access to medicines is one measure: the WHO reports that only 29% of low-income countries say cancer medicines are generally available, against 96% of high-income countries.^[4] The same divide shows up cancer by cancer, from leukaemia to brain tumours; our articles on survival around the world and brain tumours give the cancer-specific figures from the earlier CONCORD-3 round.

Teenagers and young adults sit between two systems, and for some cancers they still do worse

Teenagers and young adults get a different mix of cancers from younger children, and they are treated at the boundary between children's and adults' services. Overall, survival in this age group has risen, and in the UK and US figures below it is now similar to, or higher than, survival in children. In the UK, five-year survival for teenagers and young adults aged 15 to 24 rose from 79% for those diagnosed in 1997 to 2001 to 87% for those diagnosed in 2012 to 2016; for children aged 0 to 14 it rose from 77% to 84% over the same periods.^[7] In the United States, five-year survival for adolescents aged 15 to 19 diagnosed in 2013 to 2019 was 87.3%, up from 68% in the mid-1970s.^[6]

The overall figure hides cancers where young people still fare worse than children with the same diagnosis. The UK registry report found teenagers and young adults had worse survival than children for osteosarcoma, Ewing sarcoma and rhabdomyosarcoma, with no recent improvement; for acute lymphoid and myeloid leukaemia and non-Hodgkin lymphoma their survival was also worse, though the gap had narrowed.^[7] Across Europe, the EUROCARE-5 study (adolescents and young adults aged 15 to 39, diagnosed in 2000 to 2007) found survival "remained significantly worse in AYAs than in children for eight important cancers", including acute lymphoid and myeloid leukaemia and rhabdomyosarcoma.^[9] In its successor, EUROCARE-6, five-year relative survival for all cancers in 15 to 39 year olds was 84% in 2010 to 2014, but 59% for acute lymphoblastic leukaemia, 61% for acute myeloid leukaemia and 62% for tumours of the central nervous system.^[10]

Cancer also accounts for a notable share of deaths at these ages. In the UK in 2018 there were around 260 cancer deaths in children aged 0 to 14, 7% of all deaths at those ages, and nearly 290 in 15 to 24 year olds, 11% of all deaths in that group.^[7] Our article on blood cancers covers leukaemia and lymphoma across all ages.

Most adults treated for cancer as children in past decades live with lasting effects of treatment

As survival has risen, a growing number of adults are living after childhood cancer. The National Cancer Institute estimated that about 495,739 people diagnosed with cancer at ages 0 to 19 were alive in the United States on 1 January 2020.^[6] The longest-running studies of their health come from North America, and they show that treatment which saved lives often left lasting effects.

The Childhood Cancer Survivor Study followed 10,397 adults who had been diagnosed with childhood cancer in 1970 to 1986. In 2006 it reported that 62.3% had at least one chronic health condition and 27.5% had a severe or life-threatening one; their adjusted risk of a chronic condition was 3.3 times that of their brothers and sisters. Thirty years after diagnosis, the cumulative incidence of a chronic health condition reached 73.4%.^[11] The St Jude Lifetime Cohort went further, examining 1,713 adults (median age 32) treated for childhood cancer in clinic rather than by questionnaire. By age 45, the estimated cumulative prevalence of any chronic health condition was 95.5%, and of a serious, disabling or life-threatening condition 80.5% (95% CI 73.0% to 86.6%).^[12]

There is good news in the same data. Among 34,033 people in the Childhood Cancer Survivor Study who had lived at least five years after diagnosis, the share who died within 15 years of diagnosis fell from 12.4% for those diagnosed in the early 1970s to 6.0% for those diagnosed in the 1990s; deaths from health-related causes, including later cancers and heart and lung conditions, fell from 3.5% to 2.1%. Over the same decades, the share of children with acute lymphoblastic leukaemia given cranial radiotherapy fell from 85% in the 1970s to 19% in the 1990s.^[13] The study reported these changes side by side; it is observational, so it shows an association, not proof that one caused the other. These cohorts describe children treated decades ago, mostly in North America, and today's treatment differs. Our article on life after treatment covers late effects in adults.

What the evidence asks of us

The figures point to a small number of clear priorities for governments, health services, funders and the charities that support children and families.

• Close the survival gap between countries. The WHO's Global Initiative for Childhood Cancer aims for "at least 60% survival for all children with cancer by 2030".^[4] CONCORD-4 found most participating countries close to or already past that level, and its authors suggest the target "may not be ambitious enough"; countries without population-based registries could not be included, so their position is not known from registry data.^[1]
• Invest in whole systems, not single fixes. A Lancet Oncology Commission projected 13.7 million new childhood cancers worldwide in 2020 to 2050 and estimated that 11.1 million children would die of cancer in that period without further investment. Scaling up a package of care could avert 6.2 million of those deaths, gain 318 million life-years and return $3 for every $1 invested. These are modelled projections, published in 2020, and depend on the model's assumptions.^[14] The 2019 survival model reached a similar conclusion: single measures brought small gains, while a comprehensive package raised modelled survival for diagnosed children to 80.8%.^[2]
• Count every child. With an estimated 43% of childhood cancers never diagnosed,^[3] population-based registries and earlier recognition of childhood cancer are where progress begins: what is not counted cannot be planned for.
• Make sure medicines are there. The gap between 29% of low-income countries and 96% of high-income countries reporting that cancer medicines are generally available is a gap in supply and funding, not in need.^[4]
• Plan services around teenagers and young adults. Survival gaps for sarcomas and acute leukaemias in young people,^[7][10] and the shift between children's and adults' services, call for age-appropriate care and research that includes young people.
• Fund lifelong follow-up. With US cohort studies finding that most adults treated in childhood live with at least one chronic condition by middle age,^[12] long-term follow-up and survivorship care need to be planned and paid for across the lifespan, not left to chance.

Language: this piece says "people with cancer" and "people living with and after cancer", and describes the illness and its treatment plainly, without combat metaphors. Clinical terms such as "stage", "incidence" and "net survival" are used in the sense the cited source defines them.

Why we're publishing this

Children's and young people's cancer charities, parents' groups and hospices make the case, every day, for children and families whose needs are easily overlooked because their numbers are small. We publish this summary so that case can rest on the best available evidence, with its sources, age bands and periods in plain view. It is part of our cancer research library. The figures show both real progress and gaps that are not inevitable: where a child lives, and how old they are when cancer is found, still shape their chances, and that is a matter of services and investment, not of the child or family.

How to read this data

Three kinds of evidence appear here, and they are not interchangeable. Registry data (IICC-3, CONCORD-4, the UK National Disease Registration Service, US figures from the National Cancer Institute) count diagnosed cancers in places with population-based registries, which are mostly higher-income countries. Modelled estimates (the 2019 simulation studies, the Global Burden of Disease and the Lancet Oncology Commission) fill gaps where no registry exists; they are informed estimates with uncertainty, and depend on their assumptions; the 2019 survival estimates apply only to children whose cancer was diagnosed. Summary statements such as the WHO fact sheet do not always state a method or period. Survival figures describe children diagnosed years ago, so they lag behind current care. Net and relative survival estimate survival from cancer itself, allowing for other causes of death. Incidence is the number of new diagnoses, not the number of people living after cancer. Age bands differ between sources (0 to 14, 15 to 19, 15 to 24, 15 to 39), so figures for "young people" from different sources should not be set side by side as if they described the same group. Evidence on long-term effects comes mainly from North American cohorts of children treated in the 1970s to 1990s.

Use this data

Free to cite with attribution to Better Health For Everyone. Charities, campaigners and journalists are welcome to reuse these figures and charts. For the underlying figures as a spreadsheet, get in touch.

Important: This article summarises published research for general information. It is not medical advice and cannot be used to diagnose, treat or predict anything about an individual. If you have concerns about your own or someone else's health, please speak to a qualified health professional.

Sources

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2. Ward ZJ, Yeh JM, Bhakta N, Frazier AL, Girardi F, Atun R. Global childhood cancer survival estimates and priority-setting: a simulation-based analysis. The Lancet Oncology, 2019;20(7):972–983. europepmc.org/article/MED/31129029
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