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Cancer Incidence, Survival, and Mortality Among Adolescents and Young Adults

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Book cover Cancer in Adolescents and Young Adults

Part of the book series: Pediatric Oncology ((PEDIATRICO))

Abstract

While the epidemiology of cancer has been studied in children and older adults for more than a half century, little attention had been paid to the cancers in between those that occur in the older adolescents and young adult (AYA) between 15 and 40 years of age. Yet as recently ascertained, more than a million new cases of invasive cancer are diagnosed in AYAs annually worldwide. Not only are the array of cancers that are diagnosed in AYAs unique, accumulating evidence suggests that many are biologically distinct from what appears to be the same neoplasm in younger and older persons. AYA cancers may thereby have different etiologies and require different therapeutic strategies. Many cancers peak in incidence in AYAs, and there is an intermediate peak between the well-known childhood cancer peak and the predominant one that occurs in the elderly. If the cancers that account for the childhood peak are embryonal/fetal cancers and those that account for the peak late in life as the cancers of aging, the AYA peak may be considered as due to cancers of intermediate growth and maturation. For most of the past quarter century, the incidence of the AYA cancers has been increasing for reasons that have not been ascertained. In Europe, the United States, and Japan, the 5-year survival rates of the vast majority of cancers in AYA have been remarkably similar. In the United States, the overall rate of survival improvement had been less in AYAs than in either younger or older patients. The trends and patterns of incidence do offer certain clues as to cancer causation in AYAs and potential methods of prevention. Detailed analyses of incidence patterns by geographic region and demographic factors together with determination of variations in incidence in time and space should provide additional insights into etiology and separate lines of investigation and therapeutic opportunities.

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Author information

Authors and Affiliations

  1. Division of Cancer Control and Population Sciences (DCCPS), National Cancer Institute (Contractor), Surveillance Research Program (SRP), Surveillance, Epidemiology and End Results (SEER) Program, 9609 Medical Center Drive, Room 4E326, MSC 9765, Bethesda, MD, 20892-9765, USA

    Lynn Ries

  2. Evaluative Epidemiology Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale Tumori, via Giacomo Venezian 1, Milano, 20133, Italy

    Annalisa Trama, Gemma Gatta & Laura Botta

  3. Center for Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan

    Kayo Nakata

  4. Department of Radiation Medicine, Oregon Health and Sciences University, Portland, OR, USA

    Archie Bleyer

Authors
  1. Lynn Ries
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  2. Annalisa Trama
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  3. Kayo Nakata
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  4. Gemma Gatta
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  5. Laura Botta
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  6. Archie Bleyer
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Corresponding author

Correspondence to Lynn Ries .

Editor information

Editors and Affiliations

  1. Bend, Oregon, USA

    Archie Bleyer

  2. McMaster University, Hamilton, Ontario, Canada

    Ronald Barr

  3. RiesSearch LLC, Rockville, Maryland, USA

    Lynn Ries

  4. University College Hospital, London, United Kingdom

    Jeremy Whelan

  5. Pediatric Oncology Unit, National Tumor Institute, Milano, Italy

    Andrea Ferrari

Appendix

Appendix

Notes on which sites/histologies were used for incidence and survival except for international comparisons. For the definitions used for the international survival comparisons, see Table 2.4. Note that some chapters were limited to invasive cases while other chapters also included in situ cases separately:

  • Breast: based on SEER site recode and includes all histologies except lymphoma. Limited to female breast cancer. In situ is also presented.

  • Colon: based on the primary site codes for all segments of the colon and limited to carcinomas (8010–8599). This is different from AYA recode in that it included in situ separately and different from SEER site recode in that it excluded large intestine not otherwise specified (NOS) and is limited to carcinomas.

  • Rectum: based on the primary site codes for rectum and rectosigmoid and limited to carcinomas (8010–8599). SEER site recode for rectum which includes the rectum and all histologies except lymphoma. This is different from AYA recode in that it included in situ separately and different from SEER site recode in that it is limited to carcinomas.

  • Anus, anal canal, and anorectum: based on SEER site recode and includes invasive tumors and all histologies except lymphoma. This is included in the colon and rectum chapter. This is different from AYA recode in that it included in situ separately and different from SEER site recode in that it is limited to carcinomas.

  • Liver and intrahepatic bile duct: based on SEER site recode and includes invasive tumors only and all histologies except lymphoma.

  • Bones and joints: based on AYA recode for bone which included invasive tumors of the bone plus any site with a bone-specific histology such as osteosarcoma, chondrosarcoma, Ewing sarcoma, etc.

  • Soft-tissue sarcoma (STS): the STS chapter used the AYA definition and included all invasive STS histologies without regard to primary site. It includes Kaposi sarcoma of all sites. Invasive only. Some of these cases may also be included in other chapters. For example, leiomyosarcoma of the breast would be included in the breast and STS chapter.

  • Kaposi sarcoma: is included in STS chapter and is for all sites.

  • Melanoma: this included melanomas of all sites. In situ is also presented.

  • Ovary: based on SEER site recode and includes all histologies including epithelial and non-epithelial except lymphomas. Tables show the histology distribution.

  • Testis: based on SEER site recode and limited to invasive only. Included all histologies (except lymphoma), and very few histologies are carcinomas.

  • Brain and other nervous system: chapter included benign/borderline and invasive tumors and was limited to 2004–2011. It also included pituitary gland, craniopharyngeal duct, and pineal gland (C75.1-75.3) which is usually grouped with other endocrine and included primary brain/ONS lymphomas which were excluded from most other chapters. The histologies and sites were grouped based on CBTRUS definitions. For both malignant and benign brain tumors, the histologies were grouped with slight modification based on Table 2.2a–c from the Central Brain Tumor Registry of the United States (CBTRUS) report.

  • Thyroid: invasive cancer limited to carcinomas (AYA definition).

  • Hodgkin and non-Hodgkin lymphoma: same definition was used in AYA recode and SEER site recode.

  • Acute lymphoblastic leukemia: same definition was used in AYA recode and SEER site recode.

  • Acute myelogenous leukemia: AYA definition used which includes acute monocytic leukemia (9961) which is a separate group in the SEER site recode.

  • Chronic myelogenous leukemia: same definition was used in AYA recode and SEER site recode.

  • Urinary bladder, prostate, cervix, vagina, vulva: included in genitourinary.

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Ries, L., Trama, A., Nakata, K., Gatta, G., Botta, L., Bleyer, A. (2017). Cancer Incidence, Survival, and Mortality Among Adolescents and Young Adults. In: Bleyer, A., Barr, R., Ries, L., Whelan, J., Ferrari, A. (eds) Cancer in Adolescents and Young Adults. Pediatric Oncology. Springer, Cham. https://doi.org/10.1007/978-3-319-33679-4_2

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