Survival patterns in teenagers and young adults with cancer in the United Kingdom: Comparisons with younger and older age groups |
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Institution: | 1. From the Department of Public Health Sciences;2. Medicine, Division of Nephrology and Hypertension;3. Division of Endocrinology, Stritch School of Medicine, Loyola University Chicago, Maywood, Illinois;4. Bone Mineral Research Center, Winthrop University Hospital, Mineola, New York;5. Institute of Social & Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland & Ministry of Health, Victoria, Republic of Seychelles;6. Department of Physiology, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana;7. Tropical Medicine Research Institute, University of the West Indies, Mona, Kingston, Jamaica;8. Department of Human Biology, Division of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa.;1. Department of Pediatric Surgery, The University of Texas Medical School at Houston, Houston, Texas;2. Department of Biostatistics, The University of Texas M.D. Anderson Cancer Center, Houston, Texas;3. Department of Pediatrics, Children’s Cancer Hospital at the University of Texas M.D. Anderson Cancer Center, Houston, Texas;4. Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas |
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Abstract: | AimsWe aimed to describe and compare survival in teenagers and young adults (TYAs) with cancer to that of younger children and older adults, to identify sub-populations at greater or lesser risk of death.MethodsWe compared survival in cancer patients diagnosed in the United Kingdom aged 13–24 years (TYAs) to those aged 0–12 (children) and 25–49 years (adults) using the National Cancer Data Repository. All cases had a first cancer diagnosis between 1st January 2001 and 31st December 2005 with censor date 31st December 2010 or death if earlier.ResultsWe found six distinct statistically significant survival patterns. In pattern 1, the younger the age-group the better the 1- and 5-year survival (acute lymphoid leukaemia, carcinoma of ovary and melanoma). In pattern 2, TYAs had a worse 5-year survival than both children and young adults (bone and soft tissues sarcomas). In pattern 3, TYAs had a worse 1-year survival but no difference at 5-years (carcinoma of cervix and female breast). In pattern 4, TYAs had better 1-year survival than adults, but no difference at 5 years (carcinoma of liver and intrahepatic bile ducts, germ cell tumours of extra-gonadal sites). In pattern 5, the younger the age-group the better the 5-year survival, but the difference developed after 1-year (acute myeloid leukaemia, carcinoma of colon and rectum). In pattern 6, there was no difference in 1- and 5-year survival between TYAs and adults (testicular germ cell tumours, ovarian germ cell tumours and carcinoma of thyroid).ConclusionTYAs with specific cancer diagnoses can be grouped according to 1- and 5-year survival patterns compared to children and young adults. To further improve survival for TYAs, age-specific biology, pharmacology, proteomics, genomics, clinician and patient behaviour studies embedded within clinical trials are required. |
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Keywords: | Adolescent Young adult Teenage Neoplasms Survival analysis Cancer survival Teenager and young adult cancer Central nervous system tumours Haematological malignancies Bone tumours |
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