Survival Trends Among Adolescents and Young Adults Diagnosed With Cancer in the United States: Comparisons With Children and Older Adults

Abstract

PURPOSE Although data from 1975 to 1997 revealed a gap in cancer survival improvement in adolescents and young adults (AYAs; 15-39 years) compared with children and older adults, more recent studies have reported improvements in AYA cancer survival overall. The current analysis provides an update of 5-year relative survival and cancer survival trends among AYAs compared with children and older adults. METHODS We obtained data from the National Cancer Institute Surveillance, Epidemiology, and End Results Program for 17 regions to obtain recent (2010-2018) 5-year relative survival estimates by cancer type, stage, sex, and race/ethnicity by age group. In addition, we calculated 5-year relative survival trends during 2000-2014. RESULTS Across 33 common AYA cancers, AYAs and children had high 5-year relative survival (86%) and experienced similar survival improvements over time (average absolute change: AYAs, 0.33%; children 0.36%). Among AYAs, 73% of cancers had improvement in 5-year relative survival since 2000. Despite this overall progress, we identified cancers where survival was worse in AYAs than younger or older patients and cancers that have had either a lack of improvement (osteosarcoma and male breast) or decreases in survival (cervical and female bladder) over time. Furthermore, males had inferior survival to females for all cancers, except Kaposi sarcoma and bladder cancer, and non-Hispanic Black/African American AYAs experienced worse survival than other racial/ethnic groups for many cancers considered in this study. CONCLUSION Future studies should focus on identifying factors affecting survival disparities by age, sex, and race/ethnicity. Differences in biology, clinical trial enrollment, delivery of treatment according to clinical guidelines, and supportive and long-term survivorship care may account for the survival disparities we observed and warrant further investigation.

Kaposi’s Sarcoma: Evaluation of Clinical Features, Treatment Outcomes, and Prognosis in a Single-Center Retrospective Case Series

“…The 5-year survival in our case series is slightly higher than that which is described in a recent epidemiological study on the U.S. population, which reports a 5-year relative survival in older adults (>40 years) of 77.5% and in adolescents and young adults (AYAs, 15-39 years) of 68.7%. The worse prognosis in AYAs may be explained by the higher incidence of HIV-associated KS among young patients [38].…”

The Development and Impact of AYA Can—Canadian Cancer Advocacy: A Peer-Led Advocacy Organization for Adolescent and Young Adult Cancer in Canada

“…AYAs exist at the margins of pediatric and adult cancer care, and neither system is adequately equipped to address the needs of this population [4]. As a result, AYAs experience significant unmet needs [5,6] and poorer psychosocial and medical outcomes compared to other age groups [7,8].…”

“…Often referred to as cancer's "forgotten generation" [9], AYAs experience health disparities across the cancer continuum. Survival rates for AYAs have not kept pace with improvements achieved for cancers in children and older adults [7] due in part to systemic factors such as delays in diagnosis, inadequate accrual of AYAs into clinical trials, and lack of funding and research for AYA cancers [3,10,11]. AYA cancer survivors, who, given their age, will live for several decades beyond their diagnosis, face disproportionately greater medical, psychosocial, and financial impacts compared to older adult survivors [12].…”

Multi-omic validation of the cuproptosis-sphingolipid metabolism network: modulating the immune landscape in osteosarcoma

“…Osteosarcoma, an intensely aggressive malignant tumor originating from bone, predominantly affects adolescents (1)(2)(3). Recent studies have revealed that disruptions in metabolic pathways and alterations in the immune microenvironment significantly contribute to the pathogenesis of osteosarcoma (4-7).…”