Finding and Diagnosing Adolescent and Young Adult (AYA) Cancer

Cancers are often found at a more advanced stage in adolescents and young adults than in other age groups. This can happen for several reasons.

Sometimes, the symptoms of cancer can be mistaken for more common health problems. Competing priorities such as school, work, family, and finances can delay seeking care. Most AYA cancers are diagnosed after signs or symptoms develop.

Screening tests may prevent or catch certain cancers early before symptoms, but screening for most cancers starts at age 40 or later for people at average risk. There aren’t screening tests for every type of cancer.

Cancer screening for AYA cancers

Cancer screening is testing done to detect disease or precancers before symptoms start. Most screenings for people at average risk of cancer aren’t recommended until age 40 or later.

However, adolescents and young adults with a cervix should be screened for cervical cancer. The American Cancer Society recommends that women and other people with a cervix start screening at age 25. For more information about cervical cancer screening, see the American Cancer Society Guideline for Cervical Cancer Screening.

Healthcare teams may recommend that adolescents and young adults with a high risk of cancer start cancer screening early. This includes some people with family cancer syndromes or people who were treated for childhood cancer. Not all cancers can be screened for. Talk to your care team if you were previously treated for cancer or have a family cancer syndrome. This can help decide when your cancer screenings should start and which ones are recommended.

Possible signs and symptoms of cancer in adolescents and young adults

Signs and symptoms of cancer in adolescents and young adults can vary depending on the type of cancer.

Delays in diagnosing AYA cancers

There are many reasons cancer in an adolescent or young adult might not be recognized right away.

Symptoms look like something else

Cancer in adolescents and young adults is uncommon. Early symptoms of cancer can overlap with those from much more common illnesses or injuries. The earliest signs of cancer, such as feeling run down, getting sick, or bumps or bruises might be ignored initially, or blamed on a more common cause.

Barriers to seeking care

Young people tend to be healthy and might not go to the doctor unless their symptoms are serious. Competing priorities such as school, work, and family might make it challenging to see a doctor right away. Adolescents and young adults might also be more likely to avoid seeing a doctor due to cost or a lack of insurance coverage.

Uncertainty about where to get treatment

Making a diagnosis and determining a treatment plan can take time. Certain AYA cancers, such as leukemia or lymphoma, might respond better to pediatric treatments. This is true even if a person is in their 20s and would typically be seen by an adult oncologist. Similarly, a 17-year-old with melanoma might best be diagnosed and treated by an adult specialist who has more experience with this disease, which is far more common in adults.

Not knowing about cancer screenings

Adolescents and young adults may not know about regular screenings they should get. Women and other people with a cervix age 25 and older are recommended to have screening tests for cervical cancer. For certain adolescents and young adults with risk factors, such as a prior history of cancer or family history of cancer, other cancer screenings may be recommended at younger ages or more often. These screening tests can prevent cancer or catch it early for adolescents and young adults at high risk.

When to see the healthcare team

The most common signs and symptoms of cancer in adolescents and young adults may be hard to notice because they are also common in other illnesses and injuries. And it’s much more likely any signs or symptoms are caused by something other than cancer. However, if there’s a sign or symptom that does not get better or go away, even one that is not on these lists, see a doctor to get checked.

You can find more information about cancer-specific signs and symptoms by looking at a specific cancer type.

What to expect when you see a healthcare professional

The healthcare team will ask about your medical history and symptoms and will then do a physical exam.

Depending on the symptoms, special types of exams or tests might be recommended. These can include:

• Blood tests
• Urine tests
• Imaging tests
• Procedures

If the doctor thinks the symptoms might be caused by cancer, they will likely refer you to a specialist. The type of doctor they refer you to will depend on your age and what type of cancer is suspected.

If an abnormal lump or unusual area is found, the doctor might want to remove some or all of it for testing. This procedure is known as a biopsy. Biopsies can be done in many ways depending on where the lump is found.

Going through testing and waiting for results can be challenging. You are not alone. If you have questions or need support, reach out to your healthcare team.