Childhood cancers

Little improvement seen for cancer outcomes in young women


An analysis of incidence, mortality and survival trends for adolescents and young adults (AYAs) with cancer has revealed minimal progress for female breast, bone, ovarian, and cervical cancers.

The US study calculated 5-year relative survival for AYAs diagnosed at age 15-39 years over a 40-year period 1975-2016.

Females had higher mortality and higher incidence rates than males overall.

“The nine cancer types with the highest mortality per 100,000 were female breast cancer (2.19); brain and other nervous system cancers (0.97); cervical cancer (0.91); colon and rectum cancer (0.88); bone, joint, and soft tissue sarcomas (combined; 0.75); ovarian cancer (0.44); lung and bronchus cancer (0.43); AML (0.40); and non-Hodgkin lymphoma (NHL; 0.40).”

The study, published in Cancer, found female breast cancer mortality declined from 1986 to 2012 but has since increased. It was also increasing in incidence from 1994 to 2016.

“Female breast cancer has the greatest burden among AYAs. Additional research is needed to determine why mortality has increased and survival has flattened in more recent years.”

Trend analysis showed cervical cancer showed a significant increase in survival for localised and regional cancer, but was flat for distant-stage cancer.

Ovarian cancer had the largest improvement in survival for distant-stage disease however survival at the localised and regional stages remained flat.

The study noted most efforts to diagnose and treat ovarian cancer have been in post menopausal women.

On the upside, 5-year relative survival has improved for most cancer types including AML, brain cancer, lung cancer, colorectal cancer, and NHL.

However the study said survival improvements in colorectal cancer over time have been outpaced by the increasing incidence of the disease in young people.

The investigators said a renewed focus including investigations of biological differences among AYA patients should drive  efforts to further improve treatment in this age group.

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