abstract
Survival patterns in teenagers and young adults with cancer in the United Kingdom: Comparisons with younger and older age groups
AIMS:
We
aimed to describe and compare survival in teenagers and young adults
(TYAs) with cancer to that of younger children and older adults, to
identify sub-populations at greater or lesser risk of death.
METHODS:
We
compared survival in cancer patients diagnosed in the United Kingdom
aged 13-24years (TYAs) to those aged 0-12 (children) and 25-49years
(adults) using the National Cancer Data Repository. All cases had a
first cancer diagnosis between 1st January 2001 and 31st December 2005
with censor date 31st December 2010 or death if earlier.
RESULTS:
We
found six distinct statistically significant survival patterns. In
pattern 1, the younger the age-group the better the 1- and 5-year
survival (acute lymphoid leukaemia,
carcinoma of ovary and melanoma). In
pattern 2, TYAs had a worse 5-year survival than both children and
young adults (bone and soft tissues sarcomas). In pattern 3, TYAs had a
worse 1-year survival but no difference at 5-years (carcinoma of cervix
and female breast). In pattern 4, TYAs had better 1-year survival than
adults, but no difference at 5years (carcinoma of liver and intrahepatic
bile ducts, germ cell tumours of extra-gonadal sites). In pattern 5,
the younger the age-group the better the 5-year survival, but the
difference developed after 1-year (acute myeloid leukaemia, carcinoma of
colon and rectum). In pattern 6, there was no difference in 1- and
5-year survival between TYAs and adults (testicular germ cell tumours,
ovarian germ cell tumours and carcinoma of thyroid).
CONCLUSION:
TYAs
with specific cancer diagnoses can be grouped according to 1- and
5-year survival patterns compared to children and young adults. To
further improve survival for TYAs, age-specific biology, pharmacology,
proteomics, genomics, clinician and patient behaviour studies embedded
within clinical trials are required.
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