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Cancer in childhood is rare. The most recent SEER Cancer Statistics Review, released in April 2018 and covering 2011–2015, shows that for ages 0–14 the incidence of all cancer sites was 16.4 per 100,000 children, with mortality 2.1 per 100,000. Five-year relative survival for the same age group was 83.8% for years 2008–2014 [1]. (Rates from the European Cancer Information System are similar but are currently available only to 2012.) As of 2015, 1 in 750 of the adult population of the United States was a long-term survivor of childhood cancer [1, 2]. Cancer is more common after puberty, with incidence rising from 12.9 for ages 5–9 to 23.3 for ages 15–19 in the United States for years 2011–2015 [1], and many of these patients will be cured by combination treatment, with surgery, chemotherapy, and radiotherapy. Long-term survivors are nevertheless at risk of developing a number of late sequelae [3], including impaired fertility, adverse pregnancy outcomes, and health problems in offspring [4–6].
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