Cancer in Adolescents and Young Adults Is ‘A Growing Health Concern’ As Cases Increase

Cancer cases in adolescents and young adults (AYAs) are on the rise and are becoming “a growing health concern,” according to a study.

“Other studies have shown these types are increasing among this age group,” said study author Nicholas Zaorsky, MD, MS, assistant professor of radiation oncology and public health sciences, in a press release. “Our data reinforces the fact that clinicians should be on the lookout for these cancers in their adolescent and young adult patients.”

Dr. Zaorsky and his fellow study authors retrospectively reviewed registry data from the Surveillance, Epidemiology, and End Results (SEER) database from Jan. 1, 1973, to Dec. 31, 2015 (SEER 9 and SEER 18). The main outcomes were incidence rates and descriptive epidemiological statistics for AYAs (aged 15-39 years) with invasive cancer.

“Adolescents and young adults are a distinct cancer population,” Dr. Zaorsky explained. “But they are often grouped together with pediatric or adult patients in research studies. It is important to study how this group is distinct so that care guidelines can be developed to address the increase in cases.”

The SEER database searches yielded 497,452 AYAs diagnosed with invasive cancer from 1973 to 2015. Most patients were female (n=293,848 [59.1%]) and White (n=397,295 [79.9%]). Increasing age was associated with increased relative incidence of carcinomas, while leukemias, lymphomas, germ cell and trophoblastic neoplasms, and neoplasms of the central nervous system decreased.

For female AYAs, the top three diagnoses over the total study period were breast carcinoma (n=72,564 [24.7%]), thyroid carcinoma (n=48,865 [16.6%]), and cervix and uterus carcinoma (n=33,828 [11.5%]). For male AYAs, they were testicular cancer (n=37,597 [18.5%]), melanoma (n=20,850 [10.2%]), and non-Hodgkin lymphoma (n=19,532 [9.6%]).

From 1973 to 2015, the rate of cancer in AYAs increased by almost 30%. The mean annual percentage change (APC) per 100,000 persons was 0.537 (95% confidence interval [CI], 0.426-0.648; P<0.001). Among both male and female AYAs, the most significant increase was seen in kidney carcinoma (APCs, 3.572 [95% CI, 3.049-4.097; P<0.001)] and 3.632 [95% CI, 3.105-4.162; P<0.001)], respectively).

The study was published in JAMA Network Open.

“These cancers all have unique risk factors,” Dr. Zaorsky said. “Now that there is a better understanding of the types of cancer that are prevalent and rising in this age group, prevention, screening, diagnosis and treatment protocols specifically targeted to this population should be developed.”