Survival from adolescent cancer.

BACKGROUND: Adolescent cancer is the leading cause of non-accidental mortality in young people. The tumour types occurring most commonly in this age group are distinctive and differ markedly from those developing in younger children and older adults.
OBJECTIVE: The aim is to present survival data for the major types of cancer and for all malignancies combined in adolescents aged from 15 to 19 years, highlighting intercountry differences, temporal trends, and age/treatment regimen comparisons of survival rates.
RESULTS: Results from European and American data show that 5-year overall survival among adolescents with cancer is approximately 73-78%, close to that observed among children. As in paediatric series, there are geographical differences, with lower survival rates in Eastern European countries. Adolescents have substantially lower survival than children for acute lymphoid leukaemia, malignant non-Hodgkin lymphoma, Ewing's tumour, osteosarcoma, soft-tissue sarcoma. Temporal improvement in survival from children cancer is twice higher than survival from adolescents malignancies.
CONCLUSION: Several reasons could explain these geographical differences, such as better referral, greater availability of complex and expensive treatment regimens, reflecting variations in health care systems and resources. Age-group variations could be explained by differences in biology and in treatment regimen, and lack of participation in clinical trials. Some are inherent in the psychosocial characteristics of these patients, such as delays in seeking medical attention, poor compliance with treatment. It is necessary to focus on cancer in adolescence, as the new frontier in oncology, and adolescents with cancer must be now the subject of specific survival analyses.