Dan Stark1, David Bowen2, Elaine Dunwoodie3, Richard Feltbower4, Rod Johnson5, Anthony Moran6, Charles Stiller7, Catherine O'Hara8. 1. St James's Institute of Oncology, Leeds Institute of Cancer and Pathology, University of Leeds and Leeds Teaching Hospitals NHS Trust, Bexley Wing, St James's Hospital, Beckett Street, Leeds LS9 7TF, UK. Electronic address: d.p.stark@leeds.ac.uk. 2. St James's Institute of Oncology, Leeds Institute of Cancer and Pathology, University of Leeds and Leeds Teaching Hospitals NHS Trust, Bexley Wing, St James's Hospital, Beckett Street, Leeds LS9 7TF, UK. Electronic address: d.bowen@nhs.net. 3. St James's Institute of Oncology, Leeds Institute of Cancer and Pathology, University of Leeds and Leeds Teaching Hospitals NHS Trust, Bexley Wing, St James's Hospital, Beckett Street, Leeds LS9 7TF, UK. Electronic address: e.h.dunwoodie@leeds.ac.uk. 4. Division of Epidemiology and Biostatistics, University of Leeds, Worsley Building, Clarendon Way, Leeds LS2 9JT, UK. Electronic address: r.g.feltbower@leeds.ac.uk. 5. St James's Institute of Oncology, Leeds Institute of Cancer and Pathology, University of Leeds and Leeds Teaching Hospitals NHS Trust, Bexley Wing, St James's Hospital, Beckett Street, Leeds LS9 7TF, UK. Electronic address: rodjohnson@nhs.net. 6. Public Health England, The Palatine Centre, 63-65 Palatine Road, Manchester M20 3LJ, UK. Electronic address: tony.moran@nhs.net. 7. Public Health England, 4150 Chancellor Court, Oxford Business Park South, Oxford OX4 2GX, UK. Electronic address: Charles.Stiller@phe.gov.uk. 8. Clinical Outcomes Unit, The Christie NHS Foundation Trust, 550 Wilmslow Road, Manchester M20 4BX, UK. Electronic address: catherine.ohara@christie.nhs.uk.
Abstract
AIMS: We aimed to describe and compare survival in teenagers and young adults (TYAs) with cancer to that of younger children and older adults, to identify sub-populations at greater or lesser risk of death. METHODS: We compared survival in cancer patients diagnosed in the United Kingdom aged 13-24 years (TYAs) to those aged 0-12 (children) and 25-49 years (adults) using the National Cancer Data Repository. All cases had a first cancer diagnosis between 1st January 2001 and 31st December 2005 with censor date 31st December 2010 or death if earlier. RESULTS: We found six distinct statistically significant survival patterns. In pattern 1, the younger the age-group the better the 1- and 5-year survival (acute lymphoid leukaemia, carcinoma of ovary and melanoma). In pattern 2, TYAs had a worse 5-year survival than both children and young adults (bone and soft tissues sarcomas). In pattern 3, TYAs had a worse 1-year survival but no difference at 5-years (carcinoma of cervix and female breast). In pattern 4, TYAs had better 1-year survival than adults, but no difference at 5 years (carcinoma of liver and intrahepatic bile ducts, germ cell tumours of extra-gonadal sites). In pattern 5, the younger the age-group the better the 5-year survival, but the difference developed after 1-year (acute myeloid leukaemia, carcinoma of colon and rectum). In pattern 6, there was no difference in 1- and 5-year survival between TYAs and adults (testicular germ cell tumours, ovarian germ cell tumours and carcinoma of thyroid). CONCLUSION: TYAs with specific cancer diagnoses can be grouped according to 1- and 5-year survival patterns compared to children and young adults. To further improve survival for TYAs, age-specific biology, pharmacology, proteomics, genomics, clinician and patient behaviour studies embedded within clinical trials are required.
AIMS: We aimed to describe and compare survival in teenagers and young adults (TYAs) with cancer to that of younger children and older adults, to identify sub-populations at greater or lesser risk of death. METHODS: We compared survival in cancerpatients diagnosed in the United Kingdom aged 13-24 years (TYAs) to those aged 0-12 (children) and 25-49 years (adults) using the National Cancer Data Repository. All cases had a first cancer diagnosis between 1st January 2001 and 31st December 2005 with censor date 31st December 2010 or death if earlier. RESULTS: We found six distinct statistically significant survival patterns. In pattern 1, the younger the age-group the better the 1- and 5-year survival (acute lymphoid leukaemia, carcinoma of ovary and melanoma). In pattern 2, TYAs had a worse 5-year survival than both children and young adults (bone and soft tissues sarcomas). In pattern 3, TYAs had a worse 1-year survival but no difference at 5-years (carcinoma of cervix and female breast). In pattern 4, TYAs had better 1-year survival than adults, but no difference at 5 years (carcinoma of liver and intrahepatic bile ducts, germ cell tumours of extra-gonadal sites). In pattern 5, the younger the age-group the better the 5-year survival, but the difference developed after 1-year (acute myeloid leukaemia, carcinoma of colon and rectum). In pattern 6, there was no difference in 1- and 5-year survival between TYAs and adults (testicular germ cell tumours, ovarian germ cell tumours and carcinoma of thyroid). CONCLUSION: TYAs with specific cancer diagnoses can be grouped according to 1- and 5-year survival patterns compared to children and young adults. To further improve survival for TYAs, age-specific biology, pharmacology, proteomics, genomics, clinician and patient behaviour studies embedded within clinical trials are required.
Keywords:
Adolescent; Bone tumours; Cancer survival; Central nervous system tumours; Haematological malignancies; Neoplasms; Survival analysis; Teenage; Teenager and young adult cancer; Young adult
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