U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

NCHS Data Brief ■ No. 257 ■ September 2016

Declines in Cancer Death Rates Among Children and 

Adolescents in the United States, 1999–2014

Sally C. Curtin, M.A., Arialdi M. Miniño, M.P.H., and Robert N. Anderson, Ph.D.

Key findings 

Data from the National 

Vital Statistics System

● During 1999–2014, the 

cancer death rate for children 

and adolescents aged 1–19 

years in the United States 

declined 20%, from 2.85 to 

2.28 per 100,000 population.

● The cancer death rate for 

males aged 1–19 years in 

2014 was 30% higher than for 

females. 

● Declines in cancer death 

rates during 1999–2014 were 

experienced among both white 

and black persons aged 1–19 

years and for all 5-year age 

groups. 

● During 1999–2014, brain 

cancer replaced leukemia as the 

most common cancer causing 

death among children and 

adolescents aged 1–19 years, 

accounting for 3 out of 10 

cancer deaths in 2014.

Since the mid-1970s, cancer death rates among children and adolescents in the 

United States showed marked declines despite a slow increase in incidence for 

some of the major types (1–3). These trends have previously been shown through 

2012. This data brief extends previous research by showing trends in cancer death 

rates through 2014 among children and adolescents aged 1–19 years in the United 

States. Cancer death rates for 1999–2014 are presented and trends are compared 

for both females and males, by 5-year age group, and for white and black children 

and adolescents. Percent distributions of cancer deaths among children and 

adolescents aged 1–19 years are shown by anatomical site for 1999 and 2014.

Keywords: malignant neoplasm • death certificate • underlying cause of death • 

National Vital Statistics System

From 1999 through 2014, cancer death rates declined for 

both males and females aged 1–19 years.

Figure 1. Cancer death rates for children and adolescents aged 1–19 years, by sex: United States, 

1999–2014 Deaths per 100,000 persons

0.0

1.0

2.0

3.0

4.0

Female

Male

Total

2014 1999 2001 2003 2005 2007 2009 2011 2013

NOTES: Decline in rates from 1999 through 2014 was statistically significant for all groups (p < 0.05). Access data table for 

Figure 1 at: http://www.cdc.gov/nchs/data/databriefs/db257_table.pdf#1.

SOURCE: NCHS, National Vital Statistics System, Mortality, ICD–10 underlying cause-of-death codes malignant neoplasms 

(C00–C97).
NCHS Data Brief ■ No. 257 ■ September 2016

■  2  ■

● The cancer death rate for children and adolescents aged 1–19 years was 20% lower in 2014 

(2.28 per 100,000) than in 1999 (2.85) (Figure 1).

● Cancer death rates declined for both females and males during the 1999–2014 period.

● The cancer death rate for females in 2014 (1.98) was 22% lower than the 1999 rate (2.54), 

while the rate for males in 2014 (2.57) was 18% lower than the 1999 rate (3.15).

● Cancer death rates in 1999–2014 for male children and adolescents aged 1–19 years were 

continually higher than for their female counterparts. During this period, the male-to-female 

rate ratios ranged from 1.1 to 1.3, and the rate ratio was 1.3 in 2014.
NCHS Data Brief ■ No. 257 ■ September 2016

■  3  ■

Cancer death rates declined between 1999 and 2014 for all age groups from 

1–19 years.

● All 5-year age groups (1–4, 5–9, 10–14, and 15–19) experienced declines in cancer death 

rates during the 1999–2014 period, with percentage declines ranging from 14% for children 

aged 5–9 years to 26% for children aged 1–4 years (Figure 2). 

● For 1999, 2006, and 2014, adolescents aged 15–19 had the highest cancer death rates of all 

age groups of children and adolescents, although the rate dropped 22% between 1999 (3.71 

per 100,000) and 2014 (2.90). The majority of this decline was during the first half of the 

period (1999–2006).

● In 1999, the cancer death rate for children aged 1–4 years (2.72) was 10% higher than for 

those aged 5–9 years (2.47). In 2006 and 2014, the cancer death rates for children aged 1–4, 

5–9, and 10–14 years were not statistically different.

Figure 2. Cancer death rates for children and adolescents aged 1–19 years, by age group: United States, 1999, 2006, 

and 2014

1999 2006 2014

5–9 10–14 15–19

Age group

1–4

Deaths per 100,000 persons

0.0

1.0

2.0

3.0

4.0

1

2.72

2.37

2.02

2.47

2.35

2.12

2.49

2.13

2.01

2

3.71

2

2.90

2

3.10

1

Significantly higher than the rate for those aged 5–9 in 1999 (p < 0.05). 2

Significantly higher than the rates for all other age groups (p < 0.05).

NOTES: Decline in rates from 1999 through 2014 was statistically significant for all groups (p < 0.05). Access data table for Figure 2 at: http://www.cdc.gov/nchs/

data/databriefs/db257_table.pdf#2. 

SOURCE: NCHS, National Vital Statistics System, Mortality, ICD–10 underlying cause-of-death codes malignant neoplasms (C00–C97).
NCHS Data Brief ■ No. 257 ■ September 2016

■  4  ■

Cancer death rates declined for both white and black children and 

adolescents aged 1–19 years.

● Cancer death rates declined from 1999 through 2014 for both white and black persons aged 

1–19 years (Figure 3).

● The cancer death rate for white children and adolescents aged 1–19 years was 17% lower 

in 2014 (2.36) than in 1999 (2.85); the decline was 23% for black children and adolescents, 

from 3.01 to 2.32.

● No statistically significant differences were observed in cancer death rates between white 

and black children and adolescents aged 1–19 years.

Figure 3. Cancer death rates for children and adolescents aged 1–19 years, by race: United States, 1999, 2006, and 2014

1999 2006 2014

White Black

2.85

2.55

2.36

3.01

2.46

2.32

Deaths per 100,000 persons

0.0

1.0

2.0

3.0

4.0

NOTES: Decline in rates from 1999 through 2014 was statistically significant for both groups (p < 0.05). Access data table for Figure 3 at: http://www.cdc.gov/nchs/

data/databriefs/db257_table.pdf#3.

SOURCE: NCHS, National Vital Statistics System, Mortality, ICD–10 underlying cause-of-death codes malignant neoplasms (C00–C97). 
NCHS Data Brief ■ No. 257 ■ September 2016

■  5  ■

During the 1999–2014 period, brain cancer replaced leukemia as the most 

common cancer causing death in children and adolescents aged 1–19 

years.

● In both 1999 and 2014, more than one-half of all cancer deaths among children and 

adolescents aged 1–19 years were attributable to either leukemia or brain cancer (Figure 4). 

These two sites combined accounted for 53.4% of all cancer deaths to persons aged 1–19 

years in 1999 and 54.8% in 2014.

● Three out of 10 cancer deaths among children and adolescents aged 1–19 years in 1999 

were due to leukemia (29.7%), the most common site, whereas about one in four were due 

to brain cancer (23.7%). By 2014, these percentages reversed and brain cancer was the most 

common site, accounting for 29.9% of total cancer deaths. 

● Other common sites of cancer causing deaths among children and adolescents aged 1–19 

years were: bone and articular cartilage (10.1% in 2014), thyroid and other endocrine glands 

(9.0%), and mesothelial and soft tissue (7.7%). These cancers, along with brain cancer and 

leukemia, accounted for more than 8 out of 10 (81.6%) cancer deaths among children and 

adolescents in 2014.

● Although accounting for a small percentage of all cancer deaths among children and 

adolescents aged 1–19 years, deaths due to cancer of the kidney and renal pelvis declined 

from 2.8% in 1999 to 1.8% in 2014. 

0

20

40

60

80

100 Unspecified site

All other specified

Liver and intrahepatic bile ducts

Kidney and renal pelvis1

Non-Hodgkin's lymphoma

Mesothelial and soft tissue

Thyroid and other endrocrine 

glands

Bone and articular cartilage

Brain1

Leukemia1

1999 2014

53.4

54.8

29.7 24.9

29.9

10.1

9.0

7.7

3.9

8.5

9.6

23.7

8.7

6.8

4.8

2.8

2.7

9.3

2.0 2.3

2.0

1.8

Percent

Figure 4. Percent distribution of cancer deaths for children and adolescents aged 1–19 years, by anatomical site: 

United States, 1999 and 2014

1

Difference in percentages for 1999 and 2014 was statistically significant (p < 0.05). 

NOTE: Access data table for Figure 4 at: http://www.cdc.gov/nchs/data/databriefs/db257_table.pdf#4.

SOURCE: NCHS, National Vital Statistics System, ICD–10 underlying cause-of-death codes: Leukemia (C91–C95), brain cancer (C71), bone and articular 

cartilage (C40–C41), thyroid and other endocrine glands (C73–C75), mesothelial and soft tissue (C45–C49), non-Hodgkin’s lymphoma (C82–C85), kidney and 

renal pelvis (C64–C65), liver and intrahepatic bile ducts (C22), all other specified sites not shown separately (C00–C97), and unspecified site (C80).
NCHS Data Brief ■ No. 257 ■ September 2016

■  6  ■

Summary

Cancer mortality among children and adolescents aged 1–19 years continued to decline 

during 1999–2014, building upon progress of the previous 3 decades (1–3). Major therapeutic 

advances in treating some forms of cancer, particularly leukemia, may have resulted in increased 

survivorship (1). The overall cancer death rate declined by one-fifth during 1999–2014, with 

all 5-year age groups experiencing declines ranging from 14% to 26%. Parity in cancer death 

rates was observed between white and black persons aged 1–19 years, with both groups 

experiencing declines during the period. More than one-half of all cancer deaths among children 

and adolescents aged 1–19 years in 1999 and 2014 were attributable to either leukemia or brain 

cancer. However, a shift occurred during the period, with brain cancer replacing leukemia as 

the leading type of cancer causing death among children and adolescents aged 1–19 years. 

Cancer death rates continued to be higher for males aged 1–19 years compared with their female 

counterparts.

Data source and methods

Mortality and population data are from the National Center for Health Statistics’ 1999–2014 

multiple cause-of-death mortality files (4). Cancer deaths are those with International 

Classification of Diseases, Tenth Revision underlying cause-of-death codes C00–C97 (5). 

Cancer deaths by specific anatomical site are classified as: Leukemia (C91–C95), brain cancer 

(C71), bone and articular cartilage (C40–C41), thyroid and other endocrine glands (C73–C75), 

mesothelial and soft tissue (C45–C49), non-Hodgkin’s lymphoma (C82–C85), kidney and renal 

pelvis (C64–C65), liver and bile ducts (C22), all other specified sites not shown separately 

(C00–C97), and unspecified site (C80).

Trends were evaluated using the Joinpoint Regression Program (6). Differences in percentages in 

Figure 4 were tested using the z test statistic at p < 0.05. Death rates are per 100,000 population 

and are based on April 1 bridged-race census counts for 2000 and 2010 and July 1 bridged-race 

estimates for 1999, 2001–1999, and 2011–2014 from the vintage 2014 postcensal series. 

Male to female differences in cancer rates were based on rate ratios calculated as the male rate 

divided by the female rate.

About the authors

Sally C. Curtin, Arialdi M. Miniño, and Robert N. Anderson are with the National Center for 

Health Statistics, Division of Vital Statistics. 
NCHS Data Brief ■ No. 257 ■ September 2016

■  7  ■

References 

1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin 66(1):7–30. 2016. 

2. Ries LAG, Smith MA, Gurney JG, Linet M, Tamra T, Young JL, Bunin GR (eds). Cancer 

incidence and survival among children and adolescents: United States SEER program 1975–1995. 

NIH Pub. No. 99–4649. Bethesda, MD: National Cancer Institute, SEER Program. 1999. 

3. Ryerson AB, Eheman CR, Altekruse SF, Ward JW, Jemal A, Sherman RL, et al. Annual 

report to the nation on the status of cancer, 1975–2012, featuring the increasing incidence of liver 

cancer. Cancer 122(9):1312–37. 2016. 

4. National Center for Health Statistics. About underlying cause of death, 1999–2014. CDC 

WONDER online database. 2016. Available from: http://wonder.cdc.gov/ucd-icd10.html.

5. WHO. International statistical classification of diseases and related health problems, tenth 

revision (ICD–10). 2008 ed. Geneva, Switzerland. 2009. 

6. National Cancer Institute. Joinpoint Regression Program (Version 3.4.3) [computer software]. 

2010.
NCHS Data Brief ■ No. 257 ■ September 2016

Suggested citation

Curtin SC, Miniño AM, Anderson RN. 

Declines in cancer death rates among 

children and adolescents in the United 

States, 1999–2014. NCHS data brief, no 

257. Hyattsville, MD: National Center for 

Health Statistics. 2016.

Copyright information

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Charles J. Rothwell, M.S., M.B.A., Director

Jennifer H. Madans, Ph.D., Associate 

Director for Science

Division of Vital Statistics

Delton Atkinson, M.P.H., M.P.H., P.M.P., 

Director

Hanyu Ni, Ph.D., M.P.H., Associate Director 

for Science

For e-mail updates on NCHS publication 

releases, subscribe online at: 

http://www.cdc.gov/nchs/govdelivery.htm.

For questions or general information

about NCHS:

Tel: 1–800–CDC–INFO (1–800–232–4636)

TTY: 1–888–232–6348

Internet: http://www.cdc.gov/nchs

Online request form: http://www.cdc.gov/info

ISSN 1941–4927 Print ed.

ISSN 1941–4935 Online ed.

DHHS Publication No. 2016–1209

CS269196

U.S. DEPARTMENT OF

HEALTH & HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

3311 Toledo Road, Room 5419

Hyattsville, MD 20782–2064

OFFICIAL BUSINESS 

PENALTY FOR PRIVATE USE, $300

For more NCHS Data Briefs, visit:

http://www.cdc.gov/nchs/products/databriefs.htm.

FIRST CLASS MAIL 

POSTAGE & FEES PAID 

CDC/NCHS

PERMIT NO. G-284