Adolescent and Young Adult Cancer Survival Rates Increase When Re-evaluated

A new way of looking at the data of adolescents and young adults (AYAs) with cancer shows survival rates among this age group are much better than previously thought.

Researchers in Los Angeles and Denver re-calculated survival rates for 15-to-39-year-olds, while taking HIV and AIDS-related cancers into consideration. They found those cancers accounted for many of the cancer deaths. When HIV and AIDS-related cancers are taken out of the equation, it turns out AYAs have among the best survival rates of any age group.

The study was published October 15, 2018 in the Journal of the National Cancer Institute.

Cancer deaths by age

Cancer is the most common cause of death due to disease among 15-to-39-year-olds. About 70,000 AYAs are diagnosed with cancer in the US every year. Previous studies based on data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program for the period of 1975 to 1997 showed AYAs had the least improvement in 5-year relative survival rates than any other age group.

The new analysis looks at SEER data for survival trends among children (age 0-14), AYAs (age 15-39) and older adults (age 40+) diagnosed with cancer from 1973 to 2009, and followed through 2014. The analysis was conducted with and without Kaposi sarcoma and non-Hodgkin lymphoma, cancer types associated with HIV and AIDS. It also looked separately at a time period before the HIV/ AIDS epidemic (1973-1977) and a time period after the HIV/AIDS epidemic (2005-2009). More than 3 million cancer cases were included in the study.

The study results show that 5-year relative survival rates were better for AYAs than other age groups before the HIV/AIDS epidemic, declined substantially during the HIV/AIDS epidemic, and then improved again after effective HIV/AIDS treatment was available to control the disease.

The authors write, “This finding concurs with a recent report that concluded AYAs have generally good outcomes after cancer diagnosis, noting their better overall health, greater ability to recover from cancer treatment, and lower mortality from other causes compared to older adults.”

Challenges in treating AYAs

Despite the encouraging findings, the study authors say treating AYAs remains challenging. This age group is characterized by the beginnings of independence, and the increased reliance on parents that accompanies a cancer diagnosis and often complicates care.

In addition, the types of cancer that affect AYAs often differ from those that affect either younger children, or older adults. When it is detected, cancer tends to be at a more advanced stage than other age groups. Most young people tend to be fairly healthy and may not go to the doctor unless they feel they really need to. And even when young people do go to the doctor, cancer is not usually high on the list of probable causes for symptoms like pain or tiredness. It’s more likely that something else is suspected of causing the symptoms. AYAs are also less likely to enroll in clinical trials.

The National Comprehensive Cancer Network (NCCN) has guidelines designed for adolescents and young adults who are dealing with cancer. These guidelines can also be helpful for caregivers, family, and friends. They include information related to diagnosis, treatment, side effects, and survivorship.