Trends in Incidence and Survival of Childhood and Adolescent Cancer in Korea, 2001–2020: Comparison with U.S. SEER Data

Purpose: Childhood cancers are rare but clinically significant. Monitoring incidence and survival trends is essential for evaluating progress in cancer control and identifying areas for improvement. Materials and Methods: We analyzed cancer incidence and survival trends among individuals aged 0-19 years in Korea using data from the Korea Central Cancer Registry from 2001 to 2020. Cancer types were classified according to the International Classification of Childhood Cancer, third edition (ICCC-3). Age-standardized incidence rates (ASRs) and annual percent changes (APCs) were calculated. Relative survival rates (RSRs) were estimated and compared with data from the US. Results: A total of 34,223 cancer cases were identified during the study period. The overall ASR was 151.3 per million person-years, with a significant increasing trend (APC 1.5%). Leukemias were the most common diagnostic group (ASR 43.7), followed by central nervous system tumors and lymphomas. Between 2001-2010 and 2011-2020, the 5-year and 10-year RSRs improved from 75.2% to 84.8% and from 72.7% to 82.7%, respectively. The largest survival gains were observed in leukemia (14.9 percentage points) and neuroblastoma (13.1 percentage points). Compared to SEER data, Korea showed similar overall survival trends, although differences remained by cancer type and age group. Conclusion: The incidence of childhood and adolescent cancers in Korea has increased, while survival has significantly improved over the past two decades. These findings highlight substantial progress in pediatric cancer care, while underscoring the need for targeted efforts for specific cancer subtypes and age groups.