Adolescent and young adult (AYA) oncology: the first A.

Whereas adolescents with cancer as a group used to have a better prognosis than children with malignant disease, trends suggest that the overall survival of 15- to 19-year-olds is now worse than in younger patients. Also, the incidence of cancer is higher in 15- to 19-year age span than during the first 15 years of life. In 2006, the U.S. National Cancer Institute (NCI) and the Lance Armstrong Foundation conducted a Program Review Group (PRG) of the Adolescent and young Adult (AYA) problem. Recommendations covered awareness, prevention/cancer control/epidemiology/risk, biology, access, health insurance, clinical care models, clinical trials/research, special populations, psychosocial/behavioral factors, health-related quality of life, and long-term effects. This Commentary reviews each of the primary executive recommendations of the PRG report with respect to their adolescent oncology perspective and application. Primary implementation of the recommendations is responsibility of a new consortium of organizations devoted to assisting adolescents and young adults with cancer, the LiveStrong Young Adult Alliance, a program of the Lance Armstrong Foundation. Prior programs included the Children's Oncology Group AYA Committee and two disease-specific initiatives: the Intergroup Consortium Against Sarcoma and a clinical trial in young adults with acute lymphoblastic leukemia that will be conducted by Cancer and Leukemia Group B, the Southwest Oncology Group, and Eastern Cooperative Oncology Group. Preliminary evidence indicates that these efforts have already had measurable success.