the distribution and determinants of disease frequency in the human population and the study of how to control health problems. internationally, the greatest variation in childhood cancer incidence occurs when comparing high-income countries to low-income ones. this may result from differences in being able to diagnose cancer, differences in risk among different ethnic or racial population subgroups, as well as differences in risk factors. an example of differing risk factors is in cases of pediatric burkitt lymphoma, a form of non-hodgkin lymphoma that sickens 6 to 7 children out of every 100,000 annually in parts of sub-saharan africa, where it is associated with a history of infection by both epstein-barr virus and malaria. in industrialized countries, burkitt lymphoma is not associated with these infectious diseases. non-hispanic white children often have a better chance of survival compared to other racial and ethnic groups. where an individual lives is one of the biggest determinants of health in the world, as illness and healthcare options can vary by an individual's postal code. united states in the united states, cancer is the second most common cause of death among children between the ages of 1 and 14 years, exceeded only by unintentional injuries such as injuries sustained in a car wreck. more than 16 out of every 100,000 children and teens in the u.s. were diagnosed with cancer, and nearly 3 of every 100,000 died from the disease. in the united states in 2012, it was estimated that there was an incidence of 12,000 new cases, and 1,300 deaths, from cancer among children 0 to 14 years of age. cancer is the second leading cause of death in males and fourth in women under the age of 20 in the united states. the survival rate of children with cancer has improved since the late 1960s which is due to improved treatment and public health measures. the estimated proportion surviving 5 years from diagnosis increased from 77.8 percent to 82.7 percent to 85.4 percent for those diagnosed in the 1990s, 2000s, and 2010–2016. statistics from the 2014 american cancer society report: ages birth to 14 sex incidence mortality observed survival % boys 178.0 23.3 81.3 girls 160.1 21.1 82.0 ages 15 to 19 sex incidence mortality observed survival % boys 237.7 34.5 80.0 girls 235.5 24.7 85.4 note: incidence and mortality rates are per 1,000,000 and age-adjusted to the 2000 us standard population. observed survival percentage is based on data from 2003-2009. sub-saharan africa a large number of children in africa live in low- and middle-income countries where there is limited access to prevention or treatment of cancer. the under-five mortality rate (u5mr), a robust indicator of child health, is at 109 per 1,000 live births. the proportion of childhood cancer is higher in africa than in developed countries, at 4.8%. kids with cancer are disadvantaged compared to kids in developed countries; therefore their statistic for childhood cancer is higher. in sub-saharan africa, 10% of children die before their 5th birthday, yet it is not due to cancer; communicable diseases such as malaria, cholera, and other infections are the leading cause of death. children with cancer are often exposed to these preventable infections and diseases. tumor registries only cover 11% of the african population, and there is a significant absence in death registration, making the mortality database unreliable. overall, there is a lack of reliable data, as there is limited funding and many diseases are largely unknown to this population. united kingdom cancer in children is rare in the uk, with an average of 1,800 diagnoses every year but contributing to less than 1% of all cancer-related deaths. age is not a confounding factor in mortality from the disease in the uk. from 2014 to 2016, approximately 230 children died from cancer, with brain/cns cancers being the most commonly fatal type. foundations and fundraising part of the proceeds from the sale of yellow silage wrappings goes to childhood cancer research, brastad, swedencurrently, there are various organizations whose main focus is fighting childhood cancer. organizations focused on childhood cancer through cancer research and/or support programs include: childhood cancer canada, young lives vs cancer and the children's cancer and leukaemia group (in united kingdom), child cancer foundation (in new zealand), children's cancer recovery foundation (in united states), american childhood cancer organization (in united states), childhood cancer support (australia) and the hayim association (in israel). alex's lemonade stand foundation allows people across the us to raise money for pediatric cancer research by organizing lemonade stands. the national pediatric cancer foundation focuses on finding less toxic and more effective treatments for pediatric cancers. this foundation works with 24 different hospitals across the us in search of treatments effective in practice. childhood cancer international is the largest global pediatric cancer foundation. it focuses on early access to care for childhood cancers, focusing on patient support and patient advocacy. according to estimates by experts in the field of pediatric cancer, by 2020, cancer will cost $158 million annually for both research and treatment which marks a 27% increase since 2010. ways in which the foundations are helped by people include writing checks, collecting spare coins, bake/lemonade sales, donating portions of purchases from stores or restaurants, or paid time off donations as well as auctions, bike rides, dance-a-thons. additionally, many of the major foundations have donation buttons on their respective websites. in addition to advancing research focusing on cancer, the foundations also offer support to families whose children are affected by the disease. the estimated total cost for one child with cancer (medical costs and lost parental wages) is $833,000. organizations such as the national children's cancer society and the leukemia and lymphoma society can provide financial assistance for the costs associated with childhood cancer like medical care, home care, child care, and transportation. importance of family support the emotional challenges that a parent may encounter can disrupt their child's treatment, parenting and support for the child who is ill and their siblings, and impact overall family stability. therefore, having a support network during this time is important. different foundations fund support groups within hospitals and online for parents and families to aid in the coping process. targeted support for siblings of children with cancer is also warranted. resources that account for family context, age, and gender can help siblings process cancer-related emotional reactions. these targeted resources help promote family activities and normal family functioning, while enhancing family adjustment over time. the foundations for pediatric cancer all fall under the 501(c)3 designation which means that they are non-profit organizations that are tax-exempt. the "international childhood cancer day" occurs annually on february 15.