Cancer in young adults 20 to 39 years of age: overview.

Among 20- to 39-year-olds, cancer causes more deaths than any other disease except depression that culminates in suicide. More females in the age group die of cancer than of the next three causes combined. Yet, substantially less attention has been given to young adults than to children and older adults, and the relative improvement in the survival rate in young adults has not kept pace with that achieved in younger or older patients. Additionally, there is evidence that a substantial proportion of the cancers in young adults have a different biology, and probably etiology/pathogenesis, than that of what appears to be the same cancer in younger or older persons. The challenges of early detection, diagnosis, treatment, and follow-up are therefore likely to be distinctly different than in persons of a different age. As an introduction to this Seminars in Oncology issue on young adults with malignant disease, this overview summarizes cancer epidemiology, risk factors, survival, racial/ethnic and gender differences, diagnostic and treatment approaches, psychosocial challenges, and current organizational research and supportive care strategies in young adults.