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Overview of Adolescent and Young Adult Cancer

  • Martin G. McCabeEmail author
Chapter

Abstract

For over a decade adolescent and young adults (AYA) with cancer have been recognised to have specific healthcare challenges. Epidemiological reports in the early 2000s noted that AYA patients had a different spectrum of cancers to that observed in children and older adults, AYAs had poorer outcomes than children with the same malignancies, and that the improvements in cancer survival observed in children and older adults had not been matched in the AYA cancer population. As a result, several countries developed initiatives that brought together clinical service and research needs to develop AYA clinical infrastructure and to deliver programmes of AYA cancer research with a view to improve cancer outcomes in this population.

Hodgkin disease and other haematological malignancies predominate during adolescence; malignant melanoma, female carcinomas and male testicular germ cell tumours become more common with advancing age. The last two decades have seen significant improvements in survival across most AYA cancers, but some malignancies, principally high grade gliomas, and some bone and soft tissue sarcomas, have shown little to no improvement in survival despite international cooperation and international collaborative research trials. The most recent EUROCARE analysis has reported that the rate of improvement in AYA cancer survival in Europe now matches that in children and adults, although for most poor prognosis cancers, survival in AYAs still lags behind that in children.

Ongoing improvements in collaborative working between paediatric and adult teams at local, national and international levels, intelligent clinical trial eligibility criteria and the continued attention of government health schemes, research funders, professional groups and patient charities will leave a legacy for future AYA patients, but significant challenges remain: reducing the pre-diagnosis period, increasing the availability, acceptability and access to clinical trials, controlling non-evidence-based variations in patient management and developing effective services for life after cancer will be key to driving further improvements in AYA cancer care.

Keywords

AYA Cancer Adolescent Teenage Young adult Epidemiology Incidence Survival 

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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Christie HospitalManchesterUK

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