Although treatment advances in pediatric cancers have resulted in increases in overall 5-year survival for children and adolescents diagnosed with cancer, many pediatric survivors face chronic health conditions as they age, as well as financial, social, and psychological challenges, according to the findings from the inaugural edition of the AACR Pediatric Cancer Progress Report 2025. In addition, significant disparities in incidence and outcomes continue to persist for minority pediatric patients and for those living in rural or socioeconomically disadvantaged areas of the country.
In this report, cancers affecting children (ages 0–14 years) and adolescents (ages 15–19 years) are collectively referred to as pediatric cancers. While a rare occurrence in children and adolescents—each year, about 15,000 children and adolescents are diagnosed with cancer in the United States—cancer is the leading cause of death by disease, and approximately 1,600 will die of cancer this year.
Celebrating the Successes in Pediatric Cancer Care
There is much to celebrate in the results detailed in the AACR Pediatric Cancer Progress Report 2025, released on December 4. According to the report:
- In the United States, the 5-year survival rate for all pediatric cancers combined has risen from 63% in the mid-1970s to 87% from 2015 to 2021. Pediatric cancer mortality declined by 57% between 1970 and 2000, and by an additional 19% from 2001 to 2023, a result of advances in risk-stratified therapy, precision medicine, and supportive care. However, while 5-year survival rates for some pediatric cancers—such as Hodgkin lymphoma, thyroid carcinoma, and retinoblastoma—exceed 90%, other cancers, including certain gliomas and sarcomas, remain among the deadliest, with 5-year survival rates below 25%. The uneven pace of progress in these cancers, according to the report, underscores the need for new research models and greater investments in drug discovery to improve outcomes for patients diagnosed with aggressive and rarer subtypes of pediatric cancers.
- Between 2015 and 2025, the U.S. Food and Drug Administration approved more than 20 molecularly targeted drugs and more than 10 immunotherapies for patients with pediatric cancers.
- Advances in precision medicine are allowing clinicians to tailor treatment intensity based on the molecular profile of a specific patient’s cancer, reducing therapy intensity for patients with a favorable disease profile and increasing it for those with a higher risk of recurrence.
- Technological innovations are propelling progress against pediatric cancers. For example, single-cell and multiomics profiling is mapping the diversity of cells within tumors; CRISPR gene editing is enabling functional testing of genetic drivers of these diseases; and artificial intelligence (AI) is accelerating the integration of genomic and imaging data to identify molecular subtypes of tumors and predict outcomes precisely.
- Advanced technologies are enabling researchers to unravel the genomics and biology of pediatric cancers and how they differ from adult cancers. The findings in the report show that up to 18% of pediatric cancers have inherited variants in cancer predisposition genes; nearly 50% of pediatric solid tumors have complex genomic rearrangements; and over 70% of childhood tumors have clinically actionable genetic alterations.
Acknowledging Ongoing Disparities in Pediatric Cancer Care
However, despite the tremendous advances made over the last 50 years in the treatment and outcomes of pediatric cancers, not all patients are benefiting from this progress, and significant disparities in incidence and outcomes remain across racial, ethnic, geographic, and socioeconomic populations. For example:
- Hispanic children have the highest cancer incidence rates in the United States.
- Non-Hispanic Black children are nearly 30% more likely to die from certain pediatric cancers than non-Hispanic White children.
- Children and adolescents living in rural or underserved parts of the country face higher mortality, often because of limited access to specialized cancer centers, clinical trials, and supportive care services.
Confronting the Long-Term Health Consequences of Childhood Cancer
As outlined in the AACR Pediatric Cancer Progress Report 2025, an estimated 60% to more than 90% of childhood cancer survivors will develop at least one chronic health condition in adulthood because of their cancer or its treatment, including heart disease, infertility, hearing loss, neurocognitive impairment, and secondary cancers. By age 50, these survivors will experience an average of 17 chronic conditions—nearly twice that of their healthy peers without a cancer history.
In addition to the physical toll of cancer, the psychological, financial, and social toll on these survivors can be profound as well. For example:
- Pediatric cancer survivors have an increased risk of developing anxiety, depression, and posttraumatic stress disorder, as well as cognitive difficulties that can interfere with educational and professional opportunities.
- These survivors are also more susceptible to major psychiatric conditions, including autism, attention-deficit disorder, bipolar disorder, major depressive disorder, and obsessive-compulsive disorder.
- The annual financial productivity loss for adult survivors of childhood cancer is $8,169 due to missed workdays, lower wages, or reduced ability to work full-time because of the late effects from cancer, compared to a financial productivity loss of $3,083 for peers without a cancer history.
- Young adult survivors are less likely to complete higher education, live independently, or marry.
A Call to Action
To ensure continued advancement in pediatric cancers, the AACR is calling on Congress and leaders at the federal health agencies to prioritize pediatric cancer research and care for patients by:
- Providing robust and sustained federal funding of at least $51.303 billion for the National Institutes of Health and $7.934 billion for the National Cancer Institute (NCI) in fiscal year 2026, and prioritizing pediatric cancer research.
- Expanding access to clinical trials and promising therapies for children and adolescents with cancer.
- Modernizing and evaluating current pediatric cancer research programs and policies to better support the development of treatments and improve patient care.
- Supporting efforts that leverage and harmonize all available data to aid pediatric cancer research.
- Fostering global and public-private partnerships to accelerate pediatric cancer research and the development of innovative treatments for patients with pediatric cancer.
Accelerating Advances Against Pediatric Cancers
“Today marks an important milestone for the cancer medicine and science community as AACR releases the first-of-its-kind progress report devoted entirely to pediatric cancer,” said Margaret Foti, PhD, MD (hc), Chief Executive Officer of AACR, during a Congressional briefing announcing the publication of the AACR Pediatric Cancer Progress Report 2025. “This comprehensive report reflects years of scientific achievement, the unwavering dedication of clinicians and researchers, and the extraordinary strength of the patients and their families whose experiences give purpose to our work. The report also highlights the impact of sustained bipartisan support from Congress, which has enabled breakthroughs against cancer that is transforming clinical outcomes for so many young patients with cancer.”
“Children with cancer who once had no treatment options now have access to targeted therapies and immunotherapies—and these are saving lives. At the same time, advances in comprehensive molecular profiling are allowing physicians to diagnose cancers with greater precision, identify inherited risk, and guide therapy that is tailored to each child’s cancer.”
“These achievements reflect what has been accomplished when scientific innovation and federal investments are working together to accelerate advances against cancer,” she concluded.
In his first public appearance since being named the 18th Director of the NCI on September 29, 2025, Anthony Letai, MD, PhD, commented that while significant progress has been made in the treatment and outcomes of pediatric cancer, gaps remain that need attention.
“This report helps highlight where those gaps are and why ongoing investment matters,” said Dr. Letai. “For instance, many pediatric cancers, including several brain tumors, have seen little or no improvement in survival for decades. Too many children still have limited or highly toxic treatment options. Also, children and adolescent and young adult survivors face serious long-term late side effects.”
“As we look to the future, AI, genomic, imaging, and large-scale data integration hold promise to offer new and better ways to understand childhood cancers and develop more precise and less toxic therapies. I look forward to partnering with all of you to continue to advance much needed progress for all children with cancer and I want to make it very clear that the NCI is committed to reducing the burden of disease for pediatric cancer.”
