A system for classifying cancers diagnosed in adolescents and young adults

Barr, Ronald D.; Ries, Lynn A. G.; Trama, Annalisa; Gatta, Gemma; Steliarova‐Foucher, Eva; Stiller, Charles; Bleyer, Archie

doi:10.1002/cncr.33041

Cited by 26 publications

(14 citation statements)

References 23 publications

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“…The adolescent and young adult cancer burden estimates presented in this study also underscore the limitations of GBD and possible opportunities to improve future assessments of the global adolescent and young adult cancer burden. 34 The classification of adolescent and young adult cancers in this study is based on the GBD cancer cause list, which has historically focused on cancers occurring in adulthood. As such, GBD 2019 did not differentiate some of the most common adolescent and young adult cancer types, such as soft tissue sarcomas and bone tumours.…”

Section: Discussionmentioning

confidence: 99%

“… 5 Future studies should use the recently updated recommendations for classification of adolescent and young adult cancers to better characterise the cancer burden in this age group and minimise the number of cancer types falling into the “other malignant neoplasms” category. 34 Additionally, the quality of the data obtained, especially from low-resource settings, might cause challenges due to underestimates or miscategorisation of less common cancer types. 10 For instance, there was an observed decrease in the proportion of adolescent and young adult cancer DALYs due to brain and CNS cancers across the SDI spectrum, with the lowest proportion in low SDI settings.…”

Section: Discussionmentioning

confidence: 99%

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The global burden of adolescent and young adult cancer in 2019: a systematic analysis for the Global Burden of Disease Study 2019

Alvarez,

Force,

et al. 2022

The Lancet Oncology

127

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Background In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15-39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults.Methods Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15-39 years to define adolescents and young adults. FindingsThere were 1•19 million (95% UI 1•11-1•28) incident cancer cases and 396 000 (370 000-425 000) deaths due to cancer among people aged 15-39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59•6 [54•5-65•7] per 100 000 person-years) and high-middle SDI countries (53•2 [48•8-57•9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14•2 [12•9-15•6] per 100 000 person-years) and middle SDI (13•6 [12•6-14•8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23•5 million (21•9-25•2) DALYs to the global burden of disease, of which 2•7% (1•9-3•6) came from YLDs and 97•3% (96•4-98•1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally.Interpretation Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The global burden of adolescent and young adult cancer in 2019: a systematic analysis for the Global Burden of Disease Study 2019

Alvarez,

Force,

et al. 2022

The Lancet Oncology

127

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“…Focusing on AYAs, the ASRs in Japanese AYAs in this study were also higher than in the previous report (ASRs of all cancers, malignant only increased from 429.7 to 523.2 in both sexes), 21 and ranked 40th out of 185 countries reported in GLOBOCAN2020 33 (Figure S2). The AYA Site Recode was adapted in this study for cancers in AYAs as cancers occurring in this generation are unique and different from cancers in both children and adults 6 . Compared to reports from the United States and the Netherlands using AYA Site Recode, 34,35 the proportion of melanoma was low among the Japanese AYAs in this study, and also among Korean AYAs, 36 which indicates genetic background could be contributing to the etiology of melanoma 37 .…”

Section: Discussionmentioning

confidence: 88%

Cancer incidence and type of treatment hospital among children, adolescents, and young adults in Japan, 2016–2018

Nakata

Matsuda²,

Hori

et al. 2023

Cancer Science

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Cancer in children, adolescents, and young adults (AYAs) although rare, is the leading disease‐specific cause of death in Japan. This study aims to investigate cancer incidence and type of treatment hospital among children and AYAs in Japan. Cancer incidence data (2016–2018) for those aged 0–39 years were obtained from the Japanese population‐based National Cancer Registry. Cancer types were classified according to the 2017 update of the International Classification of Childhood Cancer (Third Edition), and AYA Site Recode 2020 Revision. Cases were also categorized into three groups: those treated at core hospitals for pediatric cancer treatment (pediatric cancer hospitals [PCHs]), those treated at designated cancer care hospitals, and those treated at nondesignated hospitals. The age‐standardized incidence rate was 166.6 (per million‐person years) for children (age 0–14 years) and 579.0 for AYAs (age 15–39 years) (including all cancers and benign or uncertain‐behavior central nervous system [CNS] tumors). The type of cancer varied with age: hematological malignancies, blastomas, and CNS tumors were common in children under 10 years, malignant bone tumors and soft tissue sarcomas were relatively common in teenagers, and in young adults over 20 years, carcinomas in thyroid, testis, gastrointestinal, female cervix, and breast were common. The proportion of cases treated at PCHs ranged from 20% to 30% for children, 10% or less for AYAs, and differed according to age group and cancer type. Based on this information, the optimal system of cancer care should be discussed.

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“… a Cancers are grouped according to the classification scheme for tumors diagnosed in adolescents and young adults by Barr and colleagues ( 14 ). The first cancer diagnosed was counted.…”

Section: Resultsmentioning

confidence: 99%

“…The Alberta AYA Cancer Survivor Study is a retrospective, population-based cohort study of 24 460 individuals diagnosed with cancer between the ages of 15 and 39 years from 1983 to 2017 in Alberta, Canada. The cohort was established in collaboration with the Alberta Cancer Registry using the Barr et al AYA cancer classification system ( 14 ). Additional details on cohort development have been published previously ( 15 ).…”

Section: Methodsmentioning

confidence: 99%

Psychiatric Disorder Incidence Among Adolescents and Young Adults Aged 15-39 With Cancer: Population-Based Cohort

Rosgen

Moss

Fiest

et al. 2022

JNCI Cancer Spectrum

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Background Adolescent and young adult (AYA) cancer survivors face physical and psychological sequelae related to having cancer decades after treatment completion. It is unclear if AYA cancer survivors are at increased risk for late psychiatric disorders. Methods We used the Alberta AYA Cancer Survivor Study that includes five-year survivors of cancer diagnosed at 15-39 years of age during 1991 to 2013. The primary outcome was incidence of psychiatric disorder (composite outcome) including anxiety, depressive, trauma- and stressor-related, psychotic, and substance use disorders that were identified using coding algorithms for administrative health databases. A validated coding algorithm identified people who experienced a suicide attempt or event of self-harm. Secondary outcomes were incidences of diagnoses by type of psychiatric disorder. Results Among 12,116 five-year AYA cancer survivors (n = 4,634 [38%] males; n = 7,482 [62%] females), 7,426 (61%; n = 2,406 [32%] males; n = 5,020 [68%] females) were diagnosed with at least one of five psychiatric disorders occurring at least three years after cancer diagnosis. Survivors of all cancer types were most often diagnosed with anxiety (males, 39.0%, 95% confidence interval [CI] 37.6-40.4); females, 54.5%, 95%CI 53.3-55.6), depressive (males, 32.7%, 95%CI 31.3-34.0; females, 47.0%, 95%CI 45.8-48.1), and trauma- and stressor-related disorders (males, 13.5%, 95%CI 12.5-14.5; females, 22.5%, 95%CI 21.6-23.5). diagnosis. Conclusions Anxiety, depressive, and trauma- and stressor-related disorders are common amongst five-year survivors of AYA cancer. Primary, secondary, or tertiary preventive strategies for AYAs diagnosed with cancer, particularly at an early age, are needed to mitigate risk of potentially severe outcomes due to psychiatric disorders.

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A system for classifying cancers diagnosed in adolescents and young adults

Abstract: Cancer types in adolescents and young adults form a unique distribution. A system for classifying them is presented.

Cited by 26 publications

References 23 publications

The global burden of adolescent and young adult cancer in 2019: a systematic analysis for the Global Burden of Disease Study 2019

The global burden of adolescent and young adult cancer in 2019: a systematic analysis for the Global Burden of Disease Study 2019

Cancer incidence and type of treatment hospital among children, adolescents, and young adults in Japan, 2016–2018

Psychiatric Disorder Incidence Among Adolescents and Young Adults Aged 15-39 With Cancer: Population-Based Cohort

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