Adolescent and young adult oncology—past, present, and future

Abstract

There are nearly 70,000 new cancer diagnoses made annually in adolescents and young adults (AYAs) in the United States. Historically, AYA patients with cancer, aged 15 to 39 years, have not shown the same improved survival as older or younger cohorts. This article reviews the contemporary cancer incidence and survival data through 2015 for the AYA patient population based on the National Cancer Institute's Surveillance, Epidemiology, and End Results registry program and the North American Association of Central Cancer Registries. Mortality data through 2016 from the Centers for Disease Control and Prevention's National Center for Health Statistics are also described. Encouragingly, absolute and relative increases in 5‐year survival for AYA cancers have paralleled those of childhood cancers since the year 2000. There has been increasing attention to these vulnerable patients and improved partnerships and collaboration between adult and pediatric oncology; however, obstacles to the care of this population still occur at multiple levels. These vulnerabilities fall into 3 significant categories: research efforts and trial enrollment directed toward AYA malignancies, access to care and insurance coverage, and AYA‐specific psychosocial support. It is critical for providers and health care delivery systems to recognize that the AYA population remains vulnerable to provider and societal complacency.

Pediatric cancer mortality and survival in the United States, 2001‐2016

“…3 Despite improvements in mortality and survival for patients with pediatric cancers over the past 40 years, progress has been limited for some cancer types diagnosed in childhood, including bone and soft-tissue cancers. 2,[4][5][6][7] Past studies have shown higher mortality with solid tumors versus leukemia and lymphoma and have described disparities in cancer outcomes, such as lower survival for Blacks versus Whites, which warrant further exploration using more recent data. 5,[8][9][10] Thus, this study examined surveillance data for pediatric cancer since 2001 and described recent trends.…”

“…Because NPCR survival data cover 93% of the US population, it can provide a more comprehensive picture of pediatric cancer survival than past studies using the Surveillance, Epidemiology, and End Results database, that covered ≤28% of the US population at the time of these studies. 5,7 Cancer October 1, 2020…”

Colorectal cancer under 20 years old: a retrospective analysis from three tertiary hospitals

“…AYA CRCs present with more advanced stage, poorer cell differentiation, and higher prevalence of signet ring cell histology, and the primary tumors are commonly located in the left side of the colon at diagnosis. Although CRC accounted for only 2.5-3.5% of cancer incidence in adolescents from 15 to 19 years old from 2011 to 2015, the 5-year survival rate was lower than in many other cancers (Close et al 2019). Both the incidence and mortality rates of CRC are increasing in China in recent decades (Arnold et al 2017).…”

“…Colorectal cancer (CRC) is the third most common cancer in incidence and ranks second in terms of cancer-related mortality (Bray et al 2018). Adolescent and young adult (AYA) cancers accounted for 5% of all newly diagnosed invasive cancers in the United States between 2011 and 2015 (Close et al 2019). We have witnessed an overall trend of decreased incidence of CRC over the past few decades as a result of using colonoscopy and other screening modalities in the older population (Connell et al 2017).…”

The anti-neoplastic effect of doxycycline in osteosarcoma as a metalloproteinase (MMP) inhibitor: a systematic review

“…of osteosarcoma are diagnosed every year [1]. The age distribution of osteosarcoma is bimodal, as the first age peak is recorded between the first and third decades and the second smaller peak (10% of cases) in the sixth decade [1].…”