Cancer Types
Pediatric Bone Cancer
Bone cancers are among the rarest childhood cancers, about 3 to 5% of the total, and they are two biologically distinct diseases. Osteosarcoma survival has not meaningfully improved since the 1980s.
Keren, a Rally Kid diagnosed with osteosarcoma
Five numbers that define pediatric bone cancers
new U.S. bone cancer cases in children and teens each year, about 400 osteosarcoma and 200 Ewing sarcoma
NCI PDQ
of all childhood cancers, one of the rarest categories
Nature (British Journal of Cancer)
osteosarcoma and Ewing sarcoma arise from different cell types, favor different bones, and respond differently to radiation
Clinical Cancer Research (AACR)
children and teens die from bone cancer in the U.S. each year
Estimate · PubMed · NCI
osteosarcoma survival for children under 15, up from about 40% in the 1970s but flat since the 1980s
NCI PDQ
About 650 to 700 new U.S. bone cancer cases are diagnosed in children and teens each year, split roughly between osteosarcoma (about 400) and Ewing sarcoma (about 200).
Sources: NCI PDQ · osteosarcoma · Ewing sarcoma
Bone cancers make up only about 3 to 5% of all childhood cancers, making them one of the rarest categories.
Source: British Journal of Cancer · nature.com
Bone cancer is not 1 but 2 biologically distinct diseases. Osteosarcoma and Ewing sarcoma arise from different cell types, favor different bones, and respond differently to radiation.
Source: Clinical Cancer Research (AACR) · aacrjournals.org
An estimated 140-plus children and teens die from bone cancer in the U.S. each year. (Derived from bone cancer’s share of the roughly 1,590 annual U.S. childhood cancer deaths reported by NCI.)
Sources: PubMed · pubmed.ncbi.nlm.nih.gov · NCI · cancer.gov
Osteosarcoma survival for children under 15 has risen from about 40% to 72% since the 1970s, but survival has not meaningfully improved since the 1980s despite active research.
Source: NCI PDQ · cancer.gov
Most common pediatric bone cancers
Osteosarcoma and Ewing sarcoma are the two most common bone cancers in children and teens, and together they account for nearly all pediatric bone cancer diagnoses.
Osteosarcoma
The most common bone cancer in children and teens.
new U.S. cases each year, the most common childhood bone cancer
PubMed Central
survival for children under 15, up from about 40% in the 1970s; teens 15–19 improved from 56% to about 71%
NCI PDQ
survival once the cancer has spread to distant parts of the body, versus 76% if it has not spread
NCI SEER*Explorer
survival after a first relapse, dropping further with each additional relapse
PubMed Central
Think about how much technology has changed since the 1980s. A cell phone was a two-pound brick and now we carry one in our back pocket. Yet the backbone of treatment for osteosarcoma has remained largely unchanged since the 1980s. Our kids deserve that same kind of innovation.
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Osteosarcoma is the most common bone cancer in children and teens, with about 400 new U.S. cases each year.
Source: NCBI PubMed Central · PMC10437036
Survival for children under 15 has risen from about 40% to 72% since the 1970s. Teens ages 15 to 19 improved from 56% to about 71%.
Source: NCI PDQ · cancer.gov
Survival has not meaningfully improved since the 1980s, despite active research, unlike cancers such as ALL, where survival keeps climbing.
Source: NCI PDQ · cancer.gov
Survival depends heavily on stage: about 76% if the cancer has not spread, 64% with regional spread, and only about 24% if it has spread to distant parts of the body.
Source: NCI SEER*Explorer · seer.cancer.gov
Once osteosarcoma relapses, survival is poor, about 23 to 28% after a first relapse, dropping further with each additional relapse.
Source: NCBI PubMed Central · PMC10437036
Ewing Sarcoma
The second most common bone cancer in children and teens.
of cases are driven by one signature gene fusion, most often EWSR1 combined with FLI1
Journal of Clinical Oncology
survival for localized disease in children under 15, up from about 59%
NCI PDQ
5-year survival once the cancer has spread, versus 55–65% ten-year survival when it has not
Scientific Reports
survival at 5 years after relapse, dropping to 7% for children who relapse within 2 years
StatPearls
Ewing sarcoma is the second most common bone cancer in children and teens.
Source: Annals of Pediatric Surgery · springer.com
Almost all Ewing sarcomas are driven by one signature gene fusion, most often EWSR1 combined with FLI1, found in 85 to 92% of cases.
Source: Journal of Clinical Oncology · ascopubs.org
Survival for localized Ewing sarcoma in children under 15 has improved dramatically, from about 59% up to 80 to 85% with modern treatment.
Source: NCI PDQ · cancer.gov
Cancer that has spread carries a much worse outlook, 20 to 35% 5-year survival, compared with 55 to 65% ten-year survival for cancer that has not spread.
Source: Scientific Reports · nature.com
Outcomes after relapse are much worse than at diagnosis. One study found only 12% survival at 5 years, dropping to 7% for children who relapse within 2 years.
Source: StatPearls (NCBI Bookshelf)
After Treatment
Bone cancer treatment is surgical as well as medical, so its long-term effects are physical as well as systemic.
Completely removing all visible cancer by surgery, often limb sparing surgery, combined with chemotherapy is essential for any chance of cure in bone cancer.
Source: NCBI PubMed Central · PMC10437036
Survivors of limb salvage surgery or amputation face lifelong physical and functional considerations in addition to the general long-term effects of chemotherapy.
Source: NCBI PubMed Central · PMC10437036
Sources for this page
- NCI PDQ: Osteosarcoma and Undifferentiated Pleomorphic Sarcoma of Bone Treatment · cancer.gov
- NCI PDQ: Ewing Sarcoma and Undifferentiated Small Round Cell Sarcomas Treatment · cancer.gov
- National Cancer Institute: Cancer in Children and Adolescents Fact Sheet · cancer.gov
- NCI SEER*Explorer · seer.cancer.gov
- British Journal of Cancer: childhood bone cancer incidence · nature.com
- Clinical Cancer Research (AACR): osteosarcoma and Ewing sarcoma biology · aacrjournals.org
- PubMed: childhood bone cancer mortality · pubmed.ncbi.nlm.nih.gov
- NCBI PubMed Central: osteosarcoma incidence, relapse, and surgery · PMC10437036
- Annals of Pediatric Surgery: pediatric Ewing sarcoma · springer.com
- Journal of Clinical Oncology: EWSR1 fusions in Ewing sarcoma · ascopubs.org
- Scientific Reports: Ewing sarcoma survival by stage · nature.com
- StatPearls (NCBI Bookshelf): Ewing sarcoma outcomes after relapse
The National Center for Childhood Cancer is the trusted source for childhood cancer statistics. Designed for journalists and policymakers, every statistic is fully sourced and includes the original source and year of the data to support accurate reporting, informed policy, and better decisions for children with cancer.