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Duffy C, Hunger SP, Bhakta N, Denburg AE, Antillon F, Barr RD. Curing pediatric cancer: A global view. Examples from acute lymphoblastic leukemia. Cancer 2024; 130:2247-2252. [PMID: 38552145 DOI: 10.1002/cncr.35290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024]
Abstract
There is a substantial difference in observed survival among children with acute lymphoblastic leukemia in high‐income countries versus those in low‐ and middle‐income countries. This gap can be reduced considerably by multilevel investing in health systems and services with innovative frameworks such as implementation science.
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Affiliation(s)
- Caitlyn Duffy
- St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Stephen P Hunger
- Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Nickhill Bhakta
- St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | | | - Federico Antillon
- Unidad Nacional de Oncología Pediátrica and Francisco Marroquín University, Guatemala City, Guatemala
| | - Ronald D Barr
- McMaster Children's Hospital and McMaster University, Hamilton, Ontario, Canada
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Trama A, Botta L, Stiller C, Visser O, Cañete-Nieto A, Spycher B, Bielska-Lasota M, Katalinic A, Vener C, Innos K, Marcos-Gragera R, Paapsi K, Guevara M, Demuru E, Mousavi SM, Blum M, Eberle A, Ferrari A, Bernasconi A, Lasalvia P. Survival of European adolescents and young adults diagnosed with cancer in 2010-2014. Eur J Cancer 2024; 202:113558. [PMID: 38489859 DOI: 10.1016/j.ejca.2024.113558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 01/15/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND We used the comprehensive definition of AYA (age 15 to 39 years) to update 5-year relative survival (RS) estimates for AYAs in Europe and across countries and to evaluate improvements in survival over time. METHODS We used data from EUROCARE-6. We analysed 700,000 AYAs with cancer diagnosed in 2000-2013 (follow-up to 2014). We focused the analyses on the 12 most common cancers in AYA. We used period analysis to estimate 5-year RS in Europe and 5-year RS differences in 29 countries (2010-2014 period estimate) and over time (2004-06 vs. 2010-14 period estimates). FINDINGS 5-year RS for all AYA tumours was 84%, ranging from 70% to 90% for most of the 12 tumours analysed. The exceptions were acute lymphoblastic leukaemia, acute myeloid leukaemia, and central nervous system tumours, presenting survival of 59%, 61%, and 62%, respectively. Differences in survival were observed among European countries for all cancers, except thyroid cancers and ovarian germ-cell tumours. Survival improved over time for most cancers in the 15- to 39-year-old age group, but for fewer cancers in adolescents and 20- to 29-year-olds. INTERPRETATION This is the most comprehensive study to report the survival of 12 cancers in AYAs in 29 European countries. We showed variability in survival among countries most likely due to differences in stage at diagnosis, access to treatment, and lack of referral to expert centres. Survival has improved especially for haematological cancers. Further efforts are needed to improve survival for other cancers as well, especially in adolescents.
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Affiliation(s)
- Annalisa Trama
- Evaluative Epidemiology Unit, Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venenzian 1, 20133 Milan, Italy
| | - Laura Botta
- Evaluative Epidemiology Unit, Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venenzian 1, 20133 Milan, Italy
| | - Charles Stiller
- National Disease Registration Service, NHS England, 7-8 Wellington Place, Leeds LS1 4AP, UK
| | - Otto Visser
- Netherlands Comprehensive Cancer Organization, P.O. Box 19079, 3501 DB Utrecht, Netherlands
| | - Adela Cañete-Nieto
- Spanish Registry of Childhood Tumours, University of Valencia, University of Valencia, Spain; Department of Paediatrics, University of Valencia, Avda. V. Blasco Ibañez, 15, 46010 Valencia, Spain
| | - Ben Spycher
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Mittelstrasse 43, CH-3012 Bern, Switzerland
| | | | - Alexander Katalinic
- University of Lübeck, Institute for Social Medicine and Epidemiology, Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - Claudia Vener
- Epidemiology and Preventive Unit, Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venenzian 1, 20133 Milan, Italy
| | - Kaire Innos
- National Institute for Health Development, Hiiu 42, 11619 Tallinn, Estonia
| | - Rafael Marcos-Gragera
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Girona Biomedical Research Institute (IdiBGi), Universitat de Girona, Girona, Spain; Biomedical Network Research Centers of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Group of Descriptive and Analytical Epidemiology of Cancer, Josep Carreras Leukemia Research Institute, Carrer del Sol, 15 1era planta, 17004 Girona, Spain
| | - Keiu Paapsi
- National Institute for Health Development, Hiiu 42, 11619 Tallinn, Estonia
| | - Marcela Guevara
- Instituto de Salud Pública y Laboral de Navarra, 31003 Pamplona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
| | - Elena Demuru
- Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161 Rome, Italy
| | | | - Marcel Blum
- Cancer Registry East Switzerland, Flurhofstr. 7 9000 St., Gallen, Switzerland
| | - Andrea Eberle
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstrasse 30, 28359 Bremen, Germany
| | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venenzian, 1, 20133 Milan, Italy
| | - Alice Bernasconi
- Evaluative Epidemiology Unit, Epidemiology and Data Science Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Evaluative Epidemiology Unit, Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venenzian 1, 20133 Milan, Italy.
| | - Paolo Lasalvia
- Evaluative Epidemiology Unit, Epidemiology and Data Science Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Evaluative Epidemiology Unit, Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venenzian 1, 20133 Milan, Italy
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Abrahão R, Brunson A, Ruddy KJ, Li Q, Li J, Ryder MM, Chubak J, Nichols HB, Sauder CAM, Gray MF, Hahn EE, Wun T, Keegan THM. Late endocrine diseases in survivors of adolescent and young adult cancer in California: a population-based study. Br J Cancer 2024; 130:1166-1175. [PMID: 38332179 PMCID: PMC10991490 DOI: 10.1038/s41416-024-02594-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 01/16/2024] [Accepted: 01/19/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Cancer survivors have increased risk of endocrine complications, but there is a lack of information on the occurrence of specific endocrinopathies at the population-level. METHODS We used data from the California Cancer Registry (2006-2018) linked to statewide hospitalisation, emergency department, and ambulatory surgery databases. We estimated the cumulative incidence of and factors associated with endocrinopathies among adolescents and young adults (AYA, 15-39 years) who survived ≥2 years after diagnosis. RESULTS Among 59,343 AYAs, 10-year cumulative incidence was highest for diabetes (4.7%), hypothyroidism (4.6%), other thyroid (2.2%) and parathyroid disorders (1.6%). Hypothyroidism was most common in Hodgkin lymphoma, leukaemia, breast, and cervical cancer survivors, while diabetes was highest among survivors of leukaemias, non-Hodgkin lymphoma, colorectal, cervical, and breast cancer. In multivariable models, factors associated with increased hazard of endocrinopathies were treatment, advanced stage, public insurance, residence in low/middle socioeconomic neighbourhoods, older age, and non-Hispanic Black or Hispanic race/ethnicity. Haematopoietic cell transplant was associated with most endocrinopathies, while chemotherapy was associated with a higher hazard of ovarian dysfunction and hypothyroidism. CONCLUSIONS We observed a high burden of endocrinopathies among AYA cancer survivors, which varied by treatment and social factors. Evidence-based survivorship guidelines are needed for surveillance of these diseases.
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Affiliation(s)
- Renata Abrahão
- Center for Oncology Hematology Outcomes Research and Training (COHORT), Division of Hematology and Oncology, University of California Davis Comprehensive Cancer Center, Sacramento, CA, USA.
| | - Ann Brunson
- Center for Oncology Hematology Outcomes Research and Training (COHORT), Division of Hematology and Oncology, University of California Davis Comprehensive Cancer Center, Sacramento, CA, USA
| | | | - Qian Li
- Center for Oncology Hematology Outcomes Research and Training (COHORT), Division of Hematology and Oncology, University of California Davis Comprehensive Cancer Center, Sacramento, CA, USA
| | - Judy Li
- Center for Oncology Hematology Outcomes Research and Training (COHORT), Division of Hematology and Oncology, University of California Davis Comprehensive Cancer Center, Sacramento, CA, USA
| | - Mabel M Ryder
- Department of Oncology, Mayo Clinic, Rochester, MN, USA
| | - Jessica Chubak
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Hazel B Nichols
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Candice A M Sauder
- Division of Surgical Oncology, Department of Surgery, University of California Davis Medical Center, Sacramento, CA, USA
- Comprehensive Cancer Center, University of California Davis Medical Center, Sacramento, CA, USA
| | - Marlaine F Gray
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Erin E Hahn
- Kaiser Permanente Southern California, Research and Evaluation, Pasadena, CA, USA
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
| | - Ted Wun
- Center for Oncology Hematology Outcomes Research and Training (COHORT), Division of Hematology and Oncology, University of California Davis Comprehensive Cancer Center, Sacramento, CA, USA
| | - Theresa H M Keegan
- Center for Oncology Hematology Outcomes Research and Training (COHORT), Division of Hematology and Oncology, University of California Davis Comprehensive Cancer Center, Sacramento, CA, USA
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Abrahão R, Brunson A, Chubak J, Wernli KJ, Nichols HB, Chao C, Ruddy KJ, Hahn EE, Li Q, Malogolowkin MH, Sauder CAM, Kushi LH, Wun T, Keegan THM. Late venous thromboembolism in survivors of adolescent and young adult cancer: A population-based study in California. Thromb Res 2024; 235:1-7. [PMID: 38244373 PMCID: PMC10989999 DOI: 10.1016/j.thromres.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/24/2023] [Accepted: 01/02/2024] [Indexed: 01/22/2024]
Abstract
INTRODUCTION Venous thromboembolism (VTE), a common complication in cancer patients, occurs more often during the initial phase of treatment. However, information on VTE beyond the first two years after diagnosis ('late VTE') is scarce, particularly in young survivors. METHODS We examined the risk of, and factors associated with, late VTE among adolescents and young adults (AYA, 15-39 years) diagnosed with cancer (2006-2018) who survived ≥2 years. Data were obtained from the California Cancer Registry linked to hospitalization, emergency department and ambulatory surgery data. We used non-parametric models and Cox proportional hazard regression for analyses. RESULTS Among 59,343 survivors, the 10-year cumulative incidence of VTE was 1.93 % (CI 1.80-2.07). The hazard of VTE was higher among those who had active cancer, including progression from lower stages to metastatic disease (Hazard Ratio (HR) = 10.41, 95 % confidence interval (CI): 8.86-12.22), second primary cancer (HR = 2.58, CI:2.01-3.31), or metastatic disease at diagnosis (HR = 2.38, CI:1.84-3.09). The hazard of late VTE was increased among survivors who underwent hematopoietic cell transplantation, those who received radiotherapy, had a VTE history, public insurance (vs private) or non-Hispanic Black/African American race/ethnicity (vs non-Hispanic White). Patients with leukemias, lymphomas, sarcoma, melanoma, colorectal, breast, and cervical cancers had a higher VTE risk than those with thyroid cancer. CONCLUSIONS VTE risk remained elevated ≥2 years following cancer diagnosis in AYA survivors. Active cancer is a significant risk factor for VTE. Future studies might determine if late VTE should prompt evaluation for recurrence or second malignancy, if not already known.
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Affiliation(s)
- Renata Abrahão
- Center for Oncology Hematology Outcomes Research and Training (COHORT), Division of Hematology and Oncology, University of California Davis Comprehensive Cancer Center, Sacramento, CA, United States of America.
| | - Ann Brunson
- Center for Oncology Hematology Outcomes Research and Training (COHORT), Division of Hematology and Oncology, University of California Davis Comprehensive Cancer Center, Sacramento, CA, United States of America
| | - Jessica Chubak
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States of America
| | - Karen J Wernli
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States of America; Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, United States of America
| | - Hazel B Nichols
- University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, United States of America
| | - Chun Chao
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, United States of America; Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States of America
| | - Kathryn J Ruddy
- Department of Oncology, Mayo Clinic, Rochester, MN, United States of America
| | - Erin E Hahn
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, United States of America; Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States of America
| | - Qian Li
- Center for Oncology Hematology Outcomes Research and Training (COHORT), Division of Hematology and Oncology, University of California Davis Comprehensive Cancer Center, Sacramento, CA, United States of America
| | - Marcio H Malogolowkin
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of California Davis School of Medicine, Sacramento, CA, United States of America
| | - Candice A M Sauder
- Division of Surgical Oncology, Department of Surgery, University of California Davis, Sacramento, CA, United States of America; University of California Davis Comprehensive Cancer Center, Sacramento, CA, United States of America
| | - Lawrence H Kushi
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States of America
| | - Ted Wun
- Center for Oncology Hematology Outcomes Research and Training (COHORT), Division of Hematology and Oncology, University of California Davis Comprehensive Cancer Center, Sacramento, CA, United States of America
| | - Theresa H M Keegan
- Center for Oncology Hematology Outcomes Research and Training (COHORT), Division of Hematology and Oncology, University of California Davis Comprehensive Cancer Center, Sacramento, CA, United States of America
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Keegan THM, Abrahão R, Alvarez EM. Survival Trends Among Adolescents and Young Adults Diagnosed With Cancer in the United States: Comparisons With Children and Older Adults. J Clin Oncol 2024; 42:630-641. [PMID: 37883740 DOI: 10.1200/jco.23.01367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/20/2023] [Accepted: 08/17/2023] [Indexed: 10/28/2023] Open
Abstract
PURPOSE Although data from 1975 to 1997 revealed a gap in cancer survival improvement in adolescents and young adults (AYAs; 15-39 years) compared with children and older adults, more recent studies have reported improvements in AYA cancer survival overall. The current analysis provides an update of 5-year relative survival and cancer survival trends among AYAs compared with children and older adults. METHODS We obtained data from the National Cancer Institute Surveillance, Epidemiology, and End Results Program for 17 regions to obtain recent (2010-2018) 5-year relative survival estimates by cancer type, stage, sex, and race/ethnicity by age group. In addition, we calculated 5-year relative survival trends during 2000-2014. RESULTS Across 33 common AYA cancers, AYAs and children had high 5-year relative survival (86%) and experienced similar survival improvements over time (average absolute change: AYAs, 0.33%; children 0.36%). Among AYAs, 73% of cancers had improvement in 5-year relative survival since 2000. Despite this overall progress, we identified cancers where survival was worse in AYAs than younger or older patients and cancers that have had either a lack of improvement (osteosarcoma and male breast) or decreases in survival (cervical and female bladder) over time. Furthermore, males had inferior survival to females for all cancers, except Kaposi sarcoma and bladder cancer, and non-Hispanic Black/African American AYAs experienced worse survival than other racial/ethnic groups for many cancers considered in this study. CONCLUSION Future studies should focus on identifying factors affecting survival disparities by age, sex, and race/ethnicity. Differences in biology, clinical trial enrollment, delivery of treatment according to clinical guidelines, and supportive and long-term survivorship care may account for the survival disparities we observed and warrant further investigation.
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Affiliation(s)
- Theresa H M Keegan
- Division of Hematology and Oncology, Center for Oncology Hematology Outcomes Research and Training (COHORT), University of California Davis Comprehensive Cancer Center, Sacramento, CA
| | - Renata Abrahão
- Division of Hematology and Oncology, Center for Oncology Hematology Outcomes Research and Training (COHORT), University of California Davis Comprehensive Cancer Center, Sacramento, CA
| | - Elysia M Alvarez
- Division of Pediatric Hematology and Oncology, University of California Davis School of Medicine, Sacramento, CA
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van der Meer DJ, Karim-Kos HE, Elzevier HW, Dinkelman-Smit M, Kerst JM, Atema V, Lehmann V, Husson O, van der Graaf WTA. The increasing burden of testicular seminomas and non-seminomas in adolescents and young adults (AYAs): incidence, treatment, disease-specific survival and mortality trends in the Netherlands between 1989 and 2019. ESMO Open 2024; 9:102231. [PMID: 38244349 PMCID: PMC10937200 DOI: 10.1016/j.esmoop.2023.102231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/11/2023] [Accepted: 12/21/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Testicular cancer incidence among adolescents and young adults (AYAs, aged 18-39 years at diagnosis) is increasing worldwide and most patients will survive the initial disease. Still, detailed epidemiological information about testicular cancer among AYAs is scarce. This study aimed to provide a detailed overview of testicular cancer trends in incidence, treatment, long-term relative survival and mortality by histological subtype among AYAs diagnosed in the Netherlands between 1989 and 2019. MATERIALS AND METHODS Data of all malignant testicular cancers (ICD-code C62) were extracted from the Netherlands Cancer Registry. Mortality data were retrieved from Statistics Netherlands. European age-standardized incidence and mortality rates with average annual percentage change statistics and relative survival estimates up to 20 years of follow-up were calculated. RESULTS A total of 12 528 testicular cancers were diagnosed between 1989 and 2019. Comparing 1989-1999 to 2010-2019, the incidence increased from 4.4 to 11.4 for seminomas and from 5.7 to 11.1 per 100 000 person-years for non-seminomas. Rising trends were most prominent for localized disease. Radiotherapy use in localized testicular seminomas declined from 78% in 1989-1993 to 5% in 2015-2019. Meanwhile, there was a slight increase in chemotherapy use. Most AYAs with localized seminomas and non-seminomas received active surveillance only (>80%). Overall, relative survival estimates remained well above 90% even at 20 years of follow-up for both seminomas and non-seminomas. Mortality rates declined from 0.5 to 0.4 per 100 000 person-years between 1989-1999 and 2010-2019. CONCLUSIONS The incidence of seminoma and non-seminoma testicular cancers significantly increased in AYAs in the Netherlands between 1989 and 2019. There was a shift towards less-aggressive treatment regimens without negative survival effects. Relative survival estimates remained well above 90% at 20 years of follow-up in most cases. Testicular cancer mortality was already low, but has improved further over time, which makes survivorship care an important issue for these young adults.
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Affiliation(s)
- D J van der Meer
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam; Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam.
| | - H E Karim-Kos
- Princess Máxima Center for Pediatric Oncology, Utrecht; Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht
| | - H W Elzevier
- Department of Urology and Medical Decision Making, Leiden University Medical Centre, Leiden
| | - M Dinkelman-Smit
- Department of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam
| | - J M Kerst
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam
| | - V Atema
- Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht
| | - V Lehmann
- Department of Medical Psychology, Cancer Center Amsterdam, Amsterdam University Medical Center, Amsterdam; Cancer Center Amsterdam (CCA), Amsterdam
| | - O Husson
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam; Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - W T A van der Graaf
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam
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van der Meer DJ, van der Graaf WTA, van de Wal D, Karim-Kos HE, Husson O. Long-term second primary cancer risk in adolescent and young adult (15-39 years) cancer survivors: a population-based study in the Netherlands between 1989 and 2018. ESMO Open 2024; 9:102203. [PMID: 38171190 PMCID: PMC10837779 DOI: 10.1016/j.esmoop.2023.102203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Few studies have comprehensively investigated the long-term second cancer risk among adolescent and young adult (AYA, aged 15-39 years) cancer survivors. This study investigated the long-term second cancer risk by including the full range of first and second cancer combinations with at least 10 observations in the Netherlands between 1989 and 2018. MATERIALS AND METHODS First and second primary cancer data of all 6-month AYA cancer survivors were obtained from the nationwide population-based Netherlands Cancer Registry. Excess cancer risk compared to the general population was assessed with standardized incidence ratio (SIR) and absolute excess risk (AER) statistics up to 25 years after diagnosis. Cumulative incidences were estimated, using death as a competing risk factor. Analyses were carried out with and without applying multiple cancer rules. RESULTS The cohort included 99 502 AYA cancer survivors. Male survivors had a 2-fold higher risk of developing any cancer compared to the general population, whereas this was around 1.3-fold in females. AERs were 17.5 and 10.1 per 10 000 person-years for males and females. The long-term excess risk of cancer was significantly higher for most first and second primary cancer combinations, but comparable and lower risk estimates were also observed. Application of the multiple cancer rules resulted in a noticeable risk underestimation in melanoma, testicular, and breast cancer survivors. Risk outcomes remained similar in most cases otherwise. The cumulative incidence of second cancer overall increased over time up to 8.9% in males and 10.3% in females at 25 years' follow-up. Highest long-term cumulative incidences were observed among lymphoma survivors (13.3% males and 18.9% females). CONCLUSIONS AYA cancer survivors have a higher cancer risk compared to the general population for most cancers up to 25 years after their initial cancer diagnosis. Additional studies that investigate risk factors for the specific cancer type combinations are needed to develop personalized follow-up strategies.
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Affiliation(s)
- D J van der Meer
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam; Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam.
| | - W T A van der Graaf
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam
| | - D van de Wal
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam
| | - H E Karim-Kos
- Princess Máxima Center for Pediatric Oncology, Utrecht; Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht
| | - O Husson
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam; Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
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Darling HS, Mohan R, Sud R. Epidemiology of cancer in adolescents and young adults from a tertiary care hospital in Southern India. J Cancer Res Ther 2023; 19:2036-2044. [PMID: 38376314 DOI: 10.4103/jcrt.jcrt_1185_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 06/26/2022] [Indexed: 02/21/2024]
Abstract
PURPOSE This study aimed to analyze cancer pattern among adolescents and young adults (AYA) in a tertiary care center in South India. MATERIALS AND METHODS A retrospective study was undertaken from January 2018 to December 2021 on AYA cancer patients (aged 15-39 years). RESULTS Totally, 369 cases of AYA cancers were identified for analyzing the frequency and pattern of cancer distribution. The most common cancers were breast cancer, thyroid cancer, and astrocytoma. All the cancers were more common in males than in females, except for breast, thyroid, gonadal cancers, and unspecified malignant neoplasms. CONCLUSION Cancer distribution patterns are distinct among AYA in terms of epidemiology and biology.
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Affiliation(s)
- H S Darling
- Department of Medical Oncology and Hemato-oncology, Command Hospital Air Force, Bangalore, Karnataka, India
| | - Raj Mohan
- Department of Surgical Oncology, Command Hospital Air Force, Bangalore, Karnataka, India
| | - Rahul Sud
- Department of Medical Oncology, Command Hospital Air Force, Bangalore, Karnataka, India
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Altherr A, Bolliger C, Kaufmann M, Dyntar D, Scheinemann K, Michel G, Mader L, Roser K. Education, Employment, and Financial Outcomes in Adolescent and Young Adult Cancer Survivors-A Systematic Review. Curr Oncol 2023; 30:8720-8762. [PMID: 37887531 PMCID: PMC10604989 DOI: 10.3390/curroncol30100631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/11/2023] [Accepted: 09/02/2023] [Indexed: 10/28/2023] Open
Abstract
Adolescents and young adults (AYAs) with cancer face unique challenges. We aimed to describe (i) education, employment, and financial outcomes and (ii) determinants for adverse outcomes in AYA cancer survivors. We performed a systematic literature search. We included original research articles on AYA (15-39 years of age) cancer survivors (≥2 years after diagnosis) and our outcomes of interest. We narratively synthesized the results of the included articles. We included 35 articles (24 quantitative and 11 qualitative studies). Patients in education had to interrupt their education during cancer treatment, and re-entry after treatment was challenging. After treatment, most survivors were employed but started their employment at an older age than the general population. Overall, no disadvantages in income were found. Survivors reported more absent workdays than comparisons. We identified chemotherapy, radiotherapy, late effects or health problems, female sex, migration background, and lower education associated with adverse outcomes. Although most AYA cancer survivors were able to re-enter education and employment, they reported difficulties with re-entry and delays in their employment pathway. To facilitate successful re-entry, age-tailored support services should be developed and implemented.
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Affiliation(s)
- Aurelia Altherr
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
| | - Céline Bolliger
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
| | - Michaela Kaufmann
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
| | - Daniela Dyntar
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
- Cancer Registry of Central Switzerland, 6000 Lucerne, Switzerland
| | - Katrin Scheinemann
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
- Division of Hematology & Oncology, Children’s Hospital of Eastern Switzerland, 9006 St. Gallen, Switzerland
- Department of Pediatrics, McMaster Children’s Hospital and McMaster University, Hamilton, ON L8N 3Z5, Canada
| | - Gisela Michel
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
| | - Luzius Mader
- Institute of Social and Preventive Medicine, University of Bern, 3012 Bern, Switzerland;
- Cancer Registry Bern-Solothurn, University of Bern, 3008 Bern, Switzerland
| | - Katharina Roser
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
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10
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Nakata K, Matsuda T, Hori M, Sugiyama H, Tabuchi K, Miyashiro I, Matsumoto K, Yoneda A, Takita J, Shimizu C, Katanoda K. Cancer incidence and type of treatment hospital among children, adolescents, and young adults in Japan, 2016-2018. Cancer Sci 2023; 114:3770-3782. [PMID: 37414740 PMCID: PMC10475761 DOI: 10.1111/cas.15892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 06/05/2023] [Accepted: 06/09/2023] [Indexed: 07/08/2023] Open
Abstract
Cancer in children, adolescents, and young adults (AYAs) although rare, is the leading disease-specific cause of death in Japan. This study aims to investigate cancer incidence and type of treatment hospital among children and AYAs in Japan. Cancer incidence data (2016-2018) for those aged 0-39 years were obtained from the Japanese population-based National Cancer Registry. Cancer types were classified according to the 2017 update of the International Classification of Childhood Cancer (Third Edition), and AYA Site Recode 2020 Revision. Cases were also categorized into three groups: those treated at core hospitals for pediatric cancer treatment (pediatric cancer hospitals [PCHs]), those treated at designated cancer care hospitals, and those treated at nondesignated hospitals. The age-standardized incidence rate was 166.6 (per million-person years) for children (age 0-14 years) and 579.0 for AYAs (age 15-39 years) (including all cancers and benign or uncertain-behavior central nervous system [CNS] tumors). The type of cancer varied with age: hematological malignancies, blastomas, and CNS tumors were common in children under 10 years, malignant bone tumors and soft tissue sarcomas were relatively common in teenagers, and in young adults over 20 years, carcinomas in thyroid, testis, gastrointestinal, female cervix, and breast were common. The proportion of cases treated at PCHs ranged from 20% to 30% for children, 10% or less for AYAs, and differed according to age group and cancer type. Based on this information, the optimal system of cancer care should be discussed.
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Affiliation(s)
- Kayo Nakata
- Cancer Control CenterOsaka International Cancer InstituteOsakaJapan
- National Cancer Center Institute for Cancer ControlTokyoJapan
| | | | - Megumi Hori
- Department of NursingUniversity of ShizuokaShizuokaJapan
| | - Hiromi Sugiyama
- Department of EpidemiologyRadiation Effects Research FoundationHiroshimaJapan
| | - Ken Tabuchi
- Tokyo Cancer Registry, Bureau of Social Welfare and Public HealthTokyo Metropolitan GovernmentTokyoJapan
| | - Isao Miyashiro
- Cancer Control CenterOsaka International Cancer InstituteOsakaJapan
| | - Kimikazu Matsumoto
- Children's Cancer CenterNational Center for Child Health and DevelopmentTokyoJapan
| | - Akihiro Yoneda
- Division of Surgery, Surgical OncologyNational Center for Child Health and DevelopmentTokyoJapan
- Division of Pediatric Surgical OncologyNational Cancer Center HospitalTokyoJapan
| | - Junko Takita
- Department of Pediatrics, Graduate School of MedicineKyoto UniversityKyotoJapan
| | - Chikako Shimizu
- Department of Breast and Medical OncologyNational Center for Global Health and MedicineTokyoJapan
| | - Kota Katanoda
- National Cancer Center Institute for Cancer ControlTokyoJapan
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11
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Magnier O, Gofti-Laroche L, Gaspar N, Schiff I, Chevassut D, Desagneaux A, Pagnier A, Pavillet J, De Schlichting E, Bobillier-Chaumont S. Adolescents and Young Adults with Primary Brain Tumor: Description of the Care Pathway of Patients Diagnosed in Grenoble Between 2013 and 2019. J Adolesc Young Adult Oncol 2023; 12:546-554. [PMID: 36409519 DOI: 10.1089/jayao.2022.0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose: This study was undertaken to describe the Adolescents and Young Adults' (AYA-aged patients') neuro-oncology care pathways at Grenoble Alpes University Hospital according to the French health recommendations. Methods: A retrospective monocentric observational study was conducted between 2020 and 2021, on patients 13-29 years of age, diagnosed from January 2013 to 2019 in our institute with a primary brain tumor, excluding meningiomas, schwannomas, and neurinomas. The detailed analysis took into account the type of care unit (adult or pediatric), whether or not a dedicated AYA support team was involved, and various pretherapeutic actions. Results: Sixty patients were included in this study. Three of the 9 key stages of the care process were completed regardless of the type of management. Management in a pediatric oncology department seems to improve multidisciplinary discussions and access to the AYA team. Collaboration with an AYA team seems to improve the recourse to pediatric advice and supportive care. Conclusions: Increased vigilance at all key steps as defined in the recommendations of the Directorate General of Healthcare Services would significantly improve the overall quality of care for this specific population. In the absence of a dedicated AYA hospitalization unit, interdisciplinary cooperation between the different professionals of the adult and pediatric services is essential, and the involvement of the AYA mobile team is a factor that favors links and exchanges and ultimately an overall improvement in patient care and life. We propose our vision of an ideal AYA neuro-oncology care pathway.
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Affiliation(s)
- Orlane Magnier
- Department of Medical Oncology, Cancer and Blood Diseases, Grenoble Alpes University Hospital, Grenoble, France
| | - Leila Gofti-Laroche
- Department of AYA Unit and Public Health, Grenoble Alpes University Hospital, Grenoble, France
| | - Nathalie Gaspar
- French Society for the Fight against Cancer and Leukemia in Children and Adolescents and AYA Unit, Gustave Roussy Institute, Villejuif, France
| | - Isabelle Schiff
- Department of Pediatric Oncology and Hematology, Grenoble Alpes University Hospital, Grenoble, France
| | - Diane Chevassut
- Department of Medical Oncology, Cancer and Blood Diseases, Grenoble Alpes University Hospital, Grenoble, France
| | - Andréa Desagneaux
- Department of Radiation Oncology, Grenoble Alpes University Hospital, Grenoble, France
| | - Anne Pagnier
- Department of Pediatric Oncology and Hematology, Grenoble Alpes University Hospital, Grenoble, France
| | - Julien Pavillet
- Department of Medical Oncology, Cancer and Blood Diseases, Grenoble Alpes University Hospital, Grenoble, France
| | | | - Séverine Bobillier-Chaumont
- Department of AYA Unit and Pediatric Oncology and Hematology, Grenoble Alpes University Hospital, Grenoble, France
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12
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Bleyer A. Increasing Cancer in Adolescents and Young Adults: Cancer Types and Causation Implications. J Adolesc Young Adult Oncol 2023; 12:285-296. [PMID: 37074337 DOI: 10.1089/jayao.2022.0134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Abstract
Purpose: This study aimed to identify cancer incidence trends in the United States and globally in adolescents and young adults (AYAs) 15-39 years of age, by sex, and to speculate on causes for trend changes. Methods: For the United States, SEER*Stat was used to obtain average annual percent change (AAPC) trends in cancer incidence during the period 2000-2019 among 395,163 AYAs. For global data, the source was the Institute of Health Metrics and Evaluation and its sociodemographic index (SDI) classification system. Results: In the United States, the invasive cancer incidence increased during the period 2000-2019 in both females (AAPC: 1.05, 95% CI: 0.90-1.20, p << 0.001) and males (AAPC: 0.56, 95% CI: 0.43-0.69, p << 0.001). A total of 25 and 20 types of cancers increased statistically significantly in female and male AYAs, respectively. Among potential causes for the increases, the obesity epidemic in the United States strongly correlates with the overall cancer increase in both its female (Pearson correlation coefficient R2 = 0.88, p = 0.0007) and male (R2 = 0.83, p = 0.003) AYAs, as does the most common malignancy in American AYAs, breast cancer (R2 = 0.83, p = 0.003). Worldwide, cancer incidence in the age group increased steadily during the period 2000-2019 among high-middle, middle, and low-middle SDI countries, but not in low SDI countries and with slowing of increase in high SDI countries. Conclusions: The increases and their age-dependent profiles implicate several causations that are preventable, including obesity, overdiagnosis, unnecessary diagnostic radiation, human papilloma virus infection, and cannabis avoidance. The United States is beginning to reverse the increasing incidence, and prevention efforts should be augmented accordingly.
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Affiliation(s)
- Archie Bleyer
- Pediatric & Young Adult Oncology, Oregon Health & Science University, Bend, Oregon, USA
- McGovern Medical School, University of Texas, Houston, Texas, USA
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13
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Barr RD. Re: "Reducing Adolescent and Young Adult Cancer Outcome Disparities Through Optimized Care Delivery: A Blueprint from the Children's Oncology Group" by Beauchemin et al: Caring for Adolescents and Young Adults with Cancer Worldwide. J Adolesc Young Adult Oncol 2023; 12:458. [PMID: 36961386 DOI: 10.1089/jayao.2023.0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023] Open
Affiliation(s)
- Ronald D Barr
- Pediatrics and Medicine, McMaster University, Hamilton, Canada
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14
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Kubicek P, Cesne AL, Lervat C, Toulmonde M, Chevreau C, Duffaud F, Le Nail LR, Morelle M, Gaspar N, Vérité C, Castex MP, Penel N, Saada E, Causeret S, Bertucci F, Perrin C, Bompas E, Orbach D, Laurence V, Piperno-Neumann S, Anract P, Rios M, Gentet JC, Mascard É, Pannier S, Blouin P, Carrère S, Chaigneau L, Soibinet-Oudot P, Corradini N, Boudou-Rouquette P, Ruzic JC, Lebrun-Ly V, Dubray-Longeras P, Varatharajah S, Lebbe C, Ropars M, Kurtz JE, Guillemet C, Lotz JP, Berchoud J, Cherrier G, Ducimetière F, Chemin C, Italiano A, Honoré C, Desandes E, Blay JY, Gouin F, Marec-Bérard P. Management and outcomes of adolescent and young adult sarcoma patients: results from the French nationwide database NETSARC. BMC Cancer 2023; 23:69. [PMID: 36670431 PMCID: PMC9854049 DOI: 10.1186/s12885-023-10556-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 01/17/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The initial management of patients with sarcoma is a critical issue. We used the nationwide French National Cancer Institute-funded prospective sarcoma database NETSARC to report the management and oncologic outcomes in adolescents and young adults (AYAs) patients with sarcoma at the national level. PATIENTS AND METHODS NETSARC database gathers regularly monitored and updated data from patients with sarcoma. NETSARC was queried for patients (15-30 years) with sarcoma diagnosed from 2010 to 2017 for whom tumor resection had been performed. We reported management, locoregional recurrence-free survival (LRFS), progression-free survival (PFS), and overall survival (OS) in AYA treated in French reference sarcoma centers (RSC) and outside RSC (non-RSC) and conducted multivariable survival analyses adjusted for classical prognostic factors. RESULTS Among 3,227 patients aged 15-30 years with sarcoma diagnosed between 2010 and 2017, the study included 2,227 patients with surgery data available, among whom 1,290 AYAs had been operated in RSC, and 937 AYAs in non-RSC. Significant differences in compliance to guidelines were observed including pre-treatment biopsy (RSC: 85.9%; non-RSC 48.1%), pre-treatment imaging (RSC: 86.8%; non-RSC: 56.5%) and R0 margins (RSC 57.6%; non-RSC: 20.2%) (p < 0.001). 3y-OS rates were 81.1% (95%CI 78.3-83.6) in AYA in RSC and 82.7% (95%CI 79.4-85.5) in AYA in non-RSC, respectively. Whereas no significant differences in OS was observed in AYAs treated in RSC and in non-RSC, LRFS and PFS were improved in AYAs treated in RSC compared to AYAs treated in non-RSC (Hazard Ratios (HR): 0.58 and 0.83, respectively). CONCLUSIONS This study highlights the importance for AYA patients with sarcoma to be managed in national sarcoma reference centers involving multidisciplinary medical teams with paediatric and adult oncologists.
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Affiliation(s)
- Pierre Kubicek
- grid.418191.40000 0000 9437 3027Department of Medical Oncology, Institut de Cancérologie de l’Ouest, Angers, France ,grid.418116.b0000 0001 0200 3174Centre Léon Bérard, Lyon, France
| | - Axel Le Cesne
- grid.14925.3b0000 0001 2284 9388Gustave Roussy, Villejuif, France
| | - Cyril Lervat
- grid.452351.40000 0001 0131 6312Centre Oscar Lambret, Lille, France
| | - Maud Toulmonde
- grid.476460.70000 0004 0639 0505Institut Bergonié, Bordeaux, France
| | - Christine Chevreau
- grid.417829.10000 0000 9680 0846Institut Claudius Régaud IUCT Toulouse, Toulouse, France
| | | | | | - Magali Morelle
- grid.418116.b0000 0001 0200 3174Centre Léon Bérard, Lyon, France
| | - Nathalie Gaspar
- grid.14925.3b0000 0001 2284 9388Gustave Roussy, Villejuif, France
| | - Cécile Vérité
- grid.476460.70000 0004 0639 0505Institut Bergonié, Bordeaux, France
| | | | - Nicolas Penel
- grid.452351.40000 0001 0131 6312Centre Oscar Lambret, Lille, France
| | - Esma Saada
- grid.417812.90000 0004 0639 1794Centre Antoine Lacassagne, Nice, France
| | - Sylvain Causeret
- grid.418037.90000 0004 0641 1257Centre Georges François Leclerc, Dijon, France
| | - François Bertucci
- grid.418443.e0000 0004 0598 4440Institut Paoli-Calmettes, Marseille, France
| | - Christophe Perrin
- grid.417988.b0000 0000 9503 7068Centre Eugène Marquis, Rennes, France
| | - Emmanuelle Bompas
- grid.418191.40000 0000 9437 3027Institut de Cancérologie de l’Ouest, Nantes, France
| | - Daniel Orbach
- grid.418596.70000 0004 0639 6384SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), PSL Research University, Institut Curie, Paris, France
| | - Valérie Laurence
- grid.418596.70000 0004 0639 6384SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), PSL Research University, Institut Curie, Paris, France
| | - Sophie Piperno-Neumann
- grid.418596.70000 0004 0639 6384SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), PSL Research University, Institut Curie, Paris, France
| | - Philippe Anract
- grid.411784.f0000 0001 0274 3893Hôpital Cochin, Paris, France
| | - Maria Rios
- grid.452436.20000 0000 8775 4825Institut de Cancérologie de Lorraine, Nancy, France
| | | | - Éric Mascard
- grid.412134.10000 0004 0593 9113Hôpital Necker, Paris, France
| | | | - Pascale Blouin
- grid.411777.30000 0004 1765 1563CHU Tours, Tours, France
| | - Sébastien Carrère
- grid.418189.d0000 0001 2175 1768Centre Val d’Aurelle ICM, Montpellier, France
| | - Loïc Chaigneau
- grid.411158.80000 0004 0638 9213CHU Besançon, Besançon, France
| | | | | | | | | | | | | | | | - Céleste Lebbe
- grid.413328.f0000 0001 2300 6614Hôpital Saint-Louis, Paris, France
| | - Mickaël Ropars
- grid.411154.40000 0001 2175 0984CHU Rennes, Rennes, France
| | - Jean-Emmanuel Kurtz
- grid.512000.6Institut de Cancérologie Strasbourg-Europe ICANS, Strasbourg, France
| | - Cécile Guillemet
- grid.418189.d0000 0001 2175 1768Centre Henri Becquerel, Rouen, France
| | | | | | | | | | - Claire Chemin
- grid.418116.b0000 0001 0200 3174Centre Léon Bérard, Lyon, France
| | - Antoine Italiano
- grid.14925.3b0000 0001 2284 9388Gustave Roussy, Villejuif, France ,grid.476460.70000 0004 0639 0505Institut Bergonié, Bordeaux, France
| | - Charles Honoré
- grid.14925.3b0000 0001 2284 9388Gustave Roussy, Villejuif, France
| | - Emmanuel Desandes
- CHRU Nancy, Centre de Recherche en Epidémiologie et en Statistique Sorbonne-Paris Cité (CRESS), UMR 1153, INSERM, Université de Paris-Descartes, Paris, France
| | - Jean-Yves Blay
- grid.418116.b0000 0001 0200 3174Centre Léon Bérard, Lyon, France
| | - François Gouin
- grid.418116.b0000 0001 0200 3174Centre Léon Bérard, Lyon, France ,grid.277151.70000 0004 0472 0371CHU Nantes, Nantes, France
| | - Perrine Marec-Bérard
- grid.418116.b0000 0001 0200 3174Centre Léon Bérard, Lyon, France ,Institute of Pediatric Hematology and Oncology, Lyon, France
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15
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Engstrom T, Tanner S, Lee WR, Forbes C, Walker R, Bradford N, Pole JD. Patient reported outcome measure domains and tools used among adolescents and young adults with cancer: A scoping review. Crit Rev Oncol Hematol 2023; 181:103867. [PMID: 36427770 DOI: 10.1016/j.critrevonc.2022.103867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/04/2022] [Accepted: 11/04/2022] [Indexed: 11/23/2022] Open
Abstract
Adolescent and young adult (AYA) cancer patients and survivors are growing and face with distinct issues from paediatric and older cancer survivors. Hence it is important the issues they encounter are measured using appropriate Patient Reported Outcome Measures (PROMs). We searched PubMed, EMBASE, CINAHL, and PsycINFO for articles including: (1) AYAs (ages 15-39), (2) Malignant neoplasms, and (3) PROMs. This resulted in 3566 unique articles, 523 were included for full text review, of which 175 were included. These studies included 203 distinct tools to measure PROMs across 31 domains. Physical function was most frequently measured domain, followed by social, emotional and mental health. The most commonly used tools were the EORTC QLQ-C30, HADS and SF-36. PROMs used in AYA cancer patients is a complex topic, this comprehensive review serves as a useful reference for researchers, clinicians and health services who want to better understand, and improve, outcomes among their patients.
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Affiliation(s)
- Teyl Engstrom
- Centre for Health Services Research, The University of Queensland, Herston, QLD, Australia
| | - Sarah Tanner
- Centre for Health Services Research, The University of Queensland, Herston, QLD, Australia
| | - Wen Ray Lee
- Centre for Health Services Research, The University of Queensland, Herston, QLD, Australia
| | - Cheryl Forbes
- Centre for Health Services Research, The University of Queensland, Herston, QLD, Australia
| | - Rick Walker
- School of Medicine, The University of Queensland, Herston, QLD, Australia; Queensland Children's Hospital, Brisbane, QLD, Australia; Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Natalie Bradford
- Cancer and Palliative Care Outcomes Centre at Centre for Children's Health Research, Queensland University of Technology, Australia
| | - Jason D Pole
- Centre for Health Services Research, The University of Queensland, Herston, QLD, Australia; The University of Toronto, Dalla Lana School of Public Health, Toronto, ON, Canada.
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16
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Barr RD, Antillon-Klussmann F. Cancer and nutrition among children and adolescents in low- and middle-income countries. HEMATOLOGY (AMSTERDAM, NETHERLANDS) 2022; 27:987-993. [PMID: 36094475 DOI: 10.1080/16078454.2022.2115437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE : The primary purpose of this review is to investigate the relationships between cancer and nutrition in children and adolescents living in resource-poor, low- and middle-income countries (LMICs) in order to explore potential opportunities for interventions which could improve clinical outcomes in this population. METHOD : The implications of overlapping age groups of children and adolescents with cancer are examined, as are the adverse influences of under-nutrition and socio-economic deprivation on the efficacy of treatment and cancer survival. Evidence suggestive of novel avenues to enhance prospects for cure, based on increased understanding of the dynamic of nutrition and cancer, is evaluated. RESULT : Cancer adds to the burden of under-nutrition in disadvantaged populations which is reflective, in large measure, on inadequate governmental expenditure on health which demands public-private partnerships and the use of hospital-based foundations. Structured approaches to the measurement of nutritional status and the design of effective programmes of nutritional supplementation are of proven benefit. Initial results from studies of the perturbed gut microbiome hold considerable promise for further gains. CONCLUSION A large minority of children with cancer in LMICs are never diagnosed and the same may be true of adolescents. Investing in the training of nutritionists will have substantial returns as will increasing access to essential medicines. Recognition of these challenges has stimulated WHO and other entities to devise major strategies for comprehensive changes in the care of children and adolescents with cancer in LMICs, offering realistic prospects for improved clinical outcomes.
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Affiliation(s)
- Ronald D Barr
- Departments of Pediatrics and Medicine, McMaster University, Hamilton, Canada
| | - Federico Antillon-Klussmann
- Unidad Nacional de Oncología Pediátrica, and School of Medicine, Francisco Marroquín University, Guatemala, Guatemala
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17
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Speckhart SA. Cancers Among Adolescents and Young Adults in Maine 2001-2017: A Descriptive Analysis and Model for Future Studies. J Adolesc Young Adult Oncol 2022; 11:580-587. [PMID: 35856871 DOI: 10.1089/jayao.2021.0233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Purpose: Maine has had a high age-adjusted incidence rate of cancer and a high incidence rate of childhood cancer. However, it is unknown if Maine adolescents and young adults (AYAs) have a higher-than-expected cancer incidence rate. Methods: Based on the International Classification of Diseases of Oncology, Third Edition (ICD-0-3) classification system, we obtained the incidence rates of AYA cancers by state, sex, race, and ethnicity from 2001 to 2017 using CDC WONDER. Overall, all cancer rates and age-adjusted incidence rates for specific cancers were compared and ranked by state. Results: Maine had a similar overall age-adjusted cancer incidence rate among non-Hispanic white AYAs compared with the national rate from 2001 to 2017. Among non-Hispanic white AYA cancers of the respiratory system, lung and bronchial cancers, uterine cancer, female breast cancer, thyroid cancer, lymphomas, and Hodgkin's lymphoma were significantly greater in Maine than the state with the lowest incidence rate for that cancer. Specifically, Maine was ranked as one of the top 10 states for the highest incidence rate of lung cancer, uterine cancer, Hodgkin's lymphoma, thyroid cancer (males only), and female breast cancer. Conclusion: Although the cancer incidence rate among AYAs in Maine was not significantly higher than the national average, Maine AYAs had a significantly higher incidence of lung cancer, uterine cancer, Hodgkin's lymphoma, thyroid cancer, and breast cancer. This information may direct future studies to identify regional cancer risk factors in Maine, which may account for this elevated rate. The described methodology is an innovative approach to identifying states with high cancer rates and directing future studies.
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18
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Rosgen BK, Moss SJ, Fiest KM, McKillop S, Diaz RL, Barr RD, Patten SB, Deleemans J, Fidler-Benaoudia MM. Psychiatric Disorder Incidence Among Adolescents and Young Adults Aged 15-39 With Cancer: Population-Based Cohort. JNCI Cancer Spectr 2022; 6:6793865. [PMID: 36321955 PMCID: PMC9733973 DOI: 10.1093/jncics/pkac077] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/07/2022] [Accepted: 10/03/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Adolescent and young adult (AYA) cancer survivors face physical and psychological sequelae related to having cancer decades after treatment completion. It is unclear if AYA cancer survivors are at increased risk for late psychiatric disorders. METHODS We used the Alberta AYA Cancer Survivor Study that includes 5-year survivors of cancer diagnosed at age 15-39 years during 1991 to 2013. The primary outcome was incidence of psychiatric disorder (composite outcome) including anxiety, depressive, trauma- and stressor-related, psychotic, and substance use disorders that were identified using coding algorithms for administrative health databases. A validated coding algorithm identified people who experienced a suicide attempt or event of self-harm. Secondary outcomes were incidences of diagnoses by type of psychiatric disorder. RESULTS Among 12 116 AYA 5-year cancer survivors (n = 4634 [38%] males; n = 7482 [62%] females), 7426 (61%; n = 2406 [32%] males; n = 5020 [68%] females) were diagnosed with at least 1 of 5 psychiatric disorders occurring at least 3 years after cancer diagnosis. Survivors of all cancer types were most often diagnosed with anxiety (males: 39.0%, 95% confidence interval [CI] = 37.6% to 40.4%; females: 54.5%, 95% CI = 53.3% to 55.6%), depressive (males: 32.7%, 95% CI = 31.3% to 34.0%; females: 47.0%, 95% CI = 45.8% to 48.1%), and trauma- and stressor-related disorders (males: 13.5%, 95% CI =12.5% to 14.5%; females: 22.5%, 95% CI = 21.6% to 23.5%). CONCLUSIONS Anxiety, depressive, and trauma- and stressor-related disorders are common among 5-year survivors of AYA cancer. Primary, secondary, or tertiary preventive strategies for AYAs diagnosed with cancer, particularly at an early age, are needed to mitigate risk of potentially severe outcomes because of psychiatric disorders.
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Affiliation(s)
| | | | - Kirsten M Fiest
- Departments of Community Health Sciences, Critical Care Medicine, and Psychiatry, O’Brien Institute for Public Health, and Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, AB, Canada
| | - Sarah McKillop
- Division of Hematology/Oncology, Stollery Children’s Hospital, and Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Ruth L Diaz
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
| | - Ronald D Barr
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada Division of Hematology-Oncology, McMaster Children’s Hospital, Hamilton, ON, Canada
| | - Scott B Patten
- Departments of Psychiatry and Community Health Sciences, O’Brien Institute for Public Health, and Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Julie Deleemans
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Miranda M Fidler-Benaoudia
- Correspondence to: Miranda Fidler-Benaoudia, PhD, Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services and Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Room 508B, Holy Cross Center, 2210 2 St SW, Calgary, AB T2S 3C3, Canada (e-mail: )
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Ssenyonga N, Stiller C, Nakata K, Shalkow J, Redmond S, Bulliard JL, Girardi F, Fowler C, Marcos-Gragera R, Bonaventure A, Saint-Jacques N, Minicozzi P, De P, Rodríguez-Barranco M, Larønningen S, Di Carlo V, Mägi M, Valkov M, Seppä K, Wyn Huws D, Coleman MP, Allemani C. Worldwide trends in population-based survival for children, adolescents, and young adults diagnosed with leukaemia, by subtype, during 2000-14 (CONCORD-3): analysis of individual data from 258 cancer registries in 61 countries. THE LANCET. CHILD & ADOLESCENT HEALTH 2022; 6:409-431. [PMID: 35468327 DOI: 10.1016/s2352-4642(22)00095-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 02/28/2022] [Accepted: 03/17/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Leukaemias comprise a heterogenous group of haematological malignancies. In CONCORD-3, we analysed data for children (aged 0-14 years) and adults (aged 15-99 years) diagnosed with a haematological malignancy during 2000-14 in 61 countries. Here, we aimed to examine worldwide trends in survival from leukaemia, by age and morphology, in young patients (aged 0-24 years). METHODS We analysed data from 258 population-based cancer registries in 61 countries participating in CONCORD-3 that submitted data on patients diagnosed with leukaemia. We grouped patients by age as children (0-14 years), adolescents (15-19 years), and young adults (20-24 years). We categorised leukaemia subtypes according to the International Classification of Childhood Cancer (ICCC-3), updated with International Classification of Diseases for Oncology, third edition (ICD-O-3) codes. We estimated 5-year net survival by age and morphology, with 95% CIs, using the non-parametric Pohar-Perme estimator. To control for background mortality, we used life tables by country or region, single year of age, single calendar year and sex, and, where possible, by race or ethnicity. All-age survival estimates were standardised to the marginal distribution of young people with leukaemia included in the analysis. FINDINGS 164 563 young people were included in this analysis: 121 328 (73·7%) children, 22 963 (14·0%) adolescents, and 20 272 (12·3%) young adults. In 2010-14, the most common subtypes were lymphoid leukaemia (28 205 [68·2%] patients) and acute myeloid leukaemia (7863 [19·0%] patients). Age-standardised 5-year net survival in children, adolescents, and young adults for all leukaemias combined during 2010-14 varied widely, ranging from 46% in Mexico to more than 85% in Canada, Cyprus, Belgium, Denmark, Finland, and Australia. Individuals with lymphoid leukaemia had better age-standardised survival (from 43% in Ecuador to ≥80% in parts of Europe, North America, Oceania, and Asia) than those with acute myeloid leukaemia (from 32% in Peru to ≥70% in most high-income countries in Europe, North America, and Oceania). Throughout 2000-14, survival from all leukaemias combined remained consistently higher for children than adolescents and young adults, and minimal improvement was seen for adolescents and young adults in most countries. INTERPRETATION This study offers the first worldwide picture of population-based survival from leukaemia in children, adolescents, and young adults. Adolescents and young adults diagnosed with leukaemia continue to have lower survival than children. Trends in survival from leukaemia for adolescents and young adults are important indicators of the quality of cancer management in this age group. FUNDING Children with Cancer UK, the Institut National du Cancer, La Ligue Contre le Cancer, Centers for Disease Control and Prevention, Swiss Re, Swiss Cancer Research foundation, Swiss Cancer League, Rossy Family Foundation, US National Cancer Institute, and the American Cancer Society.
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Affiliation(s)
- Naomi Ssenyonga
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK.
| | - Charles Stiller
- National Cancer Registration and Analysis Service, Public Health England, Wellington House, London, UK
| | - Kayo Nakata
- Cancer Control Center, Osaka International Cancer Institute 3-1-69, Otemae, Chuo-ku, Osaka City, Osaka, Japan
| | - Jaime Shalkow
- Instituto Nacional de Pediatría, Insurgentes Cuicuilco, Coyoacán, Ciudad de México, Mexico
| | - Sheilagh Redmond
- Institute of Social and Preventive Medicine, Bern University, Bern, Switzerland
| | - Jean-Luc Bulliard
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland; Neuchâtel and Jura Tumour Registry, Neuchâtel, Switzerland
| | - Fabio Girardi
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK; Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK; Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - Christine Fowler
- Classification and Terminology, Technology and Digital Services, Ministry of Health, Wellington, New Zealand
| | | | - Audrey Bonaventure
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK; CRESS, Université de Paris, INSERM, UMR 1153, Epidemiology of Childhood and Adolescent Cancers Team, Villejuif, France
| | - Nathalie Saint-Jacques
- Department of Medicine and Community Health and Epidemiology, Centre for Clinical Research, Dalhousie University, Halifax, NS, Canada
| | - Pamela Minicozzi
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| | - Prithwish De
- Surveillance and Cancer Registry, and Research Office, Clinical Institutes and Quality Programs, Ontario Health, Toronto, ON, Canada
| | - Miguel Rodríguez-Barranco
- Granada Cancer Registry, Escuela Andaluza de Salud Pública (EASP), Cuesta del Observatorio 4, Granada, Spain
| | | | - Veronica Di Carlo
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| | - Margit Mägi
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | | | - Karri Seppä
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
| | - Dyfed Wyn Huws
- Welsh Cancer Intelligence and Surveillance Unit, Public Health Wales, Cardiff, UK
| | - Michel P Coleman
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK; Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
| | - Claudia Allemani
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
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20
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Harper AS, Diaz RL, Cortez SNR, Shack L, Amin K, Bu JV, Barr RD, Fidler-Benaoudia MM. Trends in the Incidence of Cancer Among Adolescent and Young Adults in Alberta, 1983-2017: A Population-Based Study Using Cancer Registry Data. J Adolesc Young Adult Oncol 2022; 12:185-198. [PMID: 35544316 DOI: 10.1089/jayao.2021.0223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: To describe the cancer incidence burden and trends among adolescent and young adults (AYAs) in Alberta, Canada over a 35-year period. Methods: We obtained data from the Alberta Cancer Registry on all first primary cancers, excluding non-melanoma skin cancer, diagnosed at ages 15-39 years among residents in Alberta from 1983 to 2017. Cancers were classified by using Barr's AYA cancer classification system. Age-standardized incidence rates (ASIR) and the average annual percentage change (AAPC) in incidence rates were calculated. Statistically significant changes in the AAPC during the study period were assessed using Joinpoint regression. Results: Overall, 23,652 incident cases of AYA cancer were diagnosed in Alberta. Females accounted for ∼60% of the diagnoses. AYA cancer increased significantly over the study period overall (AAPC: 0.5%; 95%CI: 0.3%-0.7%), for each sex (AAPCmale: 0.7%; 95%CI: 0.4%-0.9%; AAPCfemale: 0.4%; 95%CI: 0.2%-0.6%), and among male and female 20-39 year-olds. Although statistically significant increases were observed in 11 out of 29 cancer sites for at least a portion of the study period, with significant AAPCs ranging from 0.8% (95%CI: 0.01%-1.5%) to 6.6% (95%CI: 4.6%-8.5%), the main driver was thyroid cancer (AAPC: 3.7%; 95%CI: 3.2%-4.2%). Statistically significant decreases were observed for six cancer sites, with AAPCs ranging from -6.4% (95%CI: -8.7% to -4.1%) to -1.1% (95%CI: -1.8% to -0.5%). Conclusions: There is a growing cancer burden among AYAs in Alberta, which is driven primarily by thyroid cancer and early-onset cancers in males. These results highlight the need for etiological studies and tertiary strategies to prevent and mitigate morbidity and mortality in the AYA population.
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Affiliation(s)
- Andrew S Harper
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Canada
| | - Ruth L Diaz
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Canada
| | - Samantha N R Cortez
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Canada.,Department of Microbiology & Immunology, University of British Columbia, Vancouver, Canada
| | - Lorraine Shack
- Department of Surveillance & Reporting, Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Edmonton, Canada
| | - Khalid Amin
- Department of Surveillance & Reporting, Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Edmonton, Canada
| | - Jingyu Vickey Bu
- Department of Surveillance & Reporting, Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Edmonton, Canada
| | - Ronald D Barr
- Department of Pediatrics, McMaster University, Hamilton, Canada
| | - Miranda M Fidler-Benaoudia
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Canada.,Department of Community Health Science, University of Calgary, Calgary, Canada
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21
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Boman KK, Lannering B, von Essen L, Jarfelt M. Generalizing approaches to surveillance for complex social outcomes in broad-range patient populations-The cost in terms of lost information and subgroup utility. Cancer 2022; 128:2400-2404. [PMID: 35435237 DOI: 10.1002/cncr.34214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/22/2022] [Accepted: 03/09/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Krister K Boman
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Birgitta Lannering
- Pediatric Oncology, Department of Pediatrics, Institute of Clinical Sciences, Gothenburg University, Gothenburg, Sweden
| | - Louise von Essen
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Marianne Jarfelt
- Department of Oncology, Institute of Clinical Sciences, Gothenburg University, Gothenburg, Sweden.,Follow-Up Clinic for Adult Childhood Cancer Survivors and Cancer Rehabilitation, Sahlgrenska University Hospital, Gothenburg, Sweden
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Alvarez EM, Force LM, Xu R, Compton K, Lu D, Henrikson HJ, Kocarnik JM, Harvey JD, Pennini A, Dean FE, Fu W, Vargas MT, Keegan THM, Ariffin H, Barr RD, Erdomaeva YA, Gunasekera DS, John-Akinola YO, Ketterl TG, Kutluk T, Malogolowkin MH, Mathur P, Radhakrishnan V, Ries LAG, Rodriguez-Galindo C, Sagoyan GB, Sultan I, Abbasi B, Abbasi-Kangevari M, Abbasi-Kangevari Z, Abbastabar H, Abdelmasseh M, Abd-Elsalam S, Abdoli A, Abebe H, Abedi A, Abidi H, Abolhassani H, Abubaker Ali H, Abu-Gharbieh E, Achappa B, Acuna JM, Adedeji IA, Adegboye OA, Adnani QES, Advani SM, Afzal MS, Aghaie Meybodi M, Ahadinezhad B, Ahinkorah BO, Ahmad S, Ahmadi S, Ahmed MB, Ahmed Rashid T, Ahmed Salih Y, Aiman W, Akalu GT, Al Hamad H, Alahdab F, AlAmodi AA, Alanezi FM, Alanzi TM, Alem AZ, Alem DT, Alemayehu Y, Alhalaiqa FN, Alhassan RK, Ali S, Alicandro G, Alipour V, Aljunid SM, Alkhayyat M, Alluri S, Almasri NA, Al-Maweri SA, Almustanyir S, Al-Raddadi RM, Alvis-Guzman N, Ameyaw EK, Amini S, Amu H, Ancuceanu R, Andrei CL, Andrei T, Ansari F, Ansari-Moghaddam A, Anvari D, Anyasodor AE, Arabloo J, Arab-Zozani M, Argaw AM, Arshad M, Arulappan J, Aryannejad A, Asemi Z, Asghari Jafarabadi M, Atashzar MR, Atorkey P, Atreya A, Attia S, Aujayeb A, Ausloos M, Avila-Burgos L, Awedew AF, Ayala Quintanilla BP, Ayele AD, Ayen SS, Azab MA, Azadnajafabad S, Azami H, Azangou-Khyavy M, Azari Jafari A, Azarian G, Azzam AY, Bahadory S, Bai J, Baig AA, Baker JL, Banach M, Bärnighausen TW, Barone-Adesi F, Barra F, Barrow A, Basaleem H, Batiha AMM, Behzadifar M, Bekele NC, Belete R, Belgaumi UI, Bell AW, Berhie AY, Bhagat DS, Bhagavathula AS, Bhardwaj N, Bhardwaj P, Bhaskar S, Bhattacharyya K, Bhojaraja VS, Bibi S, Bijani A, Biondi A, Birara S, Bjørge T, Bolarinwa OA, Bolla SR, Boloor A, Braithwaite D, Brenner H, Bulamu NB, Burkart K, Bustamante-Teixeira MT, Butt NS, Butt ZA, Caetano dos Santos FL, Cao C, Cao Y, Carreras G, Catalá-López F, Cembranel F, Cerin E, Chakinala RC, Chakraborty PA, Chattu VK, Chaturvedi P, Chaurasia A, Chavan PP, Chimed-Ochir O, Choi JYJ, Christopher DJ, Chu DT, Chung MT, Conde J, Costa VM, Da'ar OB, Dadras O, Dahlawi SMA, Dai X, Damiani G, D'Amico E, Dandona L, Dandona R, Daneshpajouhnejad P, Darwish AH, Daryani A, De la Hoz FP, Debela SA, Demie TGG, Demissie GD, Demissie ZG, Denova-Gutiérrez E, Derbew Molla M, Desai R, Desta AA, Dhamnetiya D, Dharmaratne SD, Dhimal ML, Dhimal M, Dianatinasab M, Didehdar M, Diress M, Djalalinia S, Do HP, Doaei S, Dorostkar F, dos Santos WM, Drake TM, Ekholuenetale M, El Sayed I, El Sayed Zaki M, El Tantawi M, El-Abid H, Elbahnasawy MA, Elbarazi I, Elhabashy HR, Elhadi M, El-Jaafary SI, Enyew DB, Erkhembayar R, Eshrati B, Eskandarieh S, Faisaluddin M, Fares J, Farooque U, Fasanmi AO, Fatima W, Ferreira de Oliveira JMP, Ferrero S, Ferro Desideri L, Fetensa G, Filip I, Fischer F, Fisher JL, Foroutan M, Fukumoto T, Gaal PA, Gad MM, Gaewkhiew P, Gallus S, Garg T, Gebremeskel TG, Gemeda BNB, Getachew T, Ghafourifard M, Ghamari SH, Ghashghaee A, Ghassemi F, Ghith N, Gholami A, Gholizadeh Navashenaq J, Gilani SA, Ginindza TG, Gizaw AT, Glasbey JC, Goel A, Golechha M, Goleij P, Golinelli D, Gopalani SV, Gorini G, Goudarzi H, Goulart BNG, Grada A, Gubari MIM, Guerra MR, Guha A, Gupta B, Gupta S, Gupta VB, Gupta VK, Haddadi R, Hafezi-Nejad N, Hailu A, Haj-Mirzaian A, Halwani R, Hamadeh RR, Hambisa MT, Hameed S, Hamidi S, Haque S, Hariri S, Haro JM, Hasaballah AI, Hasan SMM, Hashemi SM, Hassan TS, Hassanipour S, Hay SI, Hayat K, Hebo SH, Heidari G, Heidari M, Herrera-Serna BY, Herteliu C, Heyi DZ, Hezam K, Hole MK, Holla R, Horita N, Hossain MM, Hossain MB, Hosseini MS, Hosseini M, Hosseinzadeh A, Hosseinzadeh M, Hostiuc M, Hostiuc S, Househ M, Hsairi M, Huang J, Hussein NR, Hwang BF, Ibitoye SE, Ilesanmi OS, Ilic IM, Ilic MD, Innos K, Irham LM, Islam RM, Islam SMS, Ismail NE, Isola G, Iwagami M, Jacob L, Jadidi-Niaragh F, Jain V, Jakovljevic M, Janghorban R, Javadi Mamaghani A, Jayaram S, Jayawardena R, Jazayeri SB, Jebai R, Jha RP, Joo T, Joseph N, Joukar F, Jürisson M, Kaambwa B, Kabir A, Kalankesh LR, Kaliyadan F, Kamal Z, Kamath A, Kandel H, Kar SS, Karaye IM, Karimi A, Kassa BG, Kauppila JH, Kemp Bohan PM, Kengne AP, Kerbo AA, Keykhaei M, Khader YS, Khajuria H, Khalili N, Khalili N, Khan EA, Khan G, Khan M, Khan MN, Khan MAB, Khanali J, Khayamzadeh M, Khosravizadeh O, Khubchandani J, Khundkar R, Kim MS, Kim YJ, Kisa A, Kisa S, Kissimova-Skarbek K, Kolahi AA, Kopec JA, Koteeswaran R, Koulmane Laxminarayana SL, Koyanagi A, Kugbey N, Kumar GA, Kumar N, Kwarteng A, La Vecchia C, Lan Q, Landires I, Lasrado S, Lauriola P, Ledda C, Lee SW, Lee WC, Lee YY, Lee YH, Leigh J, Leong E, Li B, Li J, Li MC, Lim SS, Liu X, Lobo SW, Loureiro JA, Lugo A, Lunevicius R, Magdy Abd El Razek H, Magdy Abd El Razek M, Mahmoudi M, Majeed A, Makki A, Male S, Malekpour MR, Malekzadeh R, Malik AA, Mamun MA, Manafi N, Mansour-Ghanaei F, Mansouri B, Mansournia MA, Martini S, Masoumi SZ, Matei CN, Mathur MR, McAlinden C, Mehrotra R, Mendoza W, Menezes RG, Mentis AFA, Meretoja TJ, Mersha AG, Mesregah MK, Mestrovic T, Miao Jonasson J, Miazgowski B, Michalek IM, Miller TR, Mingude AB, Mirmoeeni S, Mirzaei H, Misra S, Mithra P, Mohammad KA, Mohammadi M, Mohammadi SM, Mohammadian-Hafshejani A, Mohammadpourhodki R, Mohammed A, Mohammed S, Mohammed TA, Moka N, Mokdad AH, Molokhia M, Momtazmanesh S, Monasta L, Moni MA, Moradi G, Moradi Y, Moradzadeh M, Moradzadeh R, Moraga P, Morrison SD, Mostafavi E, Mousavi Khaneghah A, Mpundu-Kaambwa C, Mubarik S, Mwanri L, Nabhan AF, Nagaraju SP, Nagata C, Naghavi M, Naimzada MD, Naldi L, Nangia V, Naqvi AA, Narasimha Swamy S, Narayana AI, Nayak BP, Nayak VC, Nazari J, Nduaguba SO, Negoi I, Negru SM, Nejadghaderi SA, Nepal S, Neupane Kandel S, Nggada HA, Nguyen CT, Nnaji CA, Nosrati H, Nouraei H, Nowroozi A, Nuñez-Samudio V, Nwatah VE, Nzoputam CI, Oancea B, Odukoya OO, Oguntade AS, Oh IH, Olagunju AT, Olagunju TO, Olakunde BO, Oluwasanu MM, Omar E, Omar Bali A, Ong S, Onwujekwe OE, Ortega-Altamirano DV, Otstavnov N, Otstavnov SS, Oumer B, Owolabi MO, P A M, Padron-Monedero A, Padubidri JR, Pakshir K, Pana A, Pandey A, Pardhan S, Pashazadeh Kan F, Pasovic M, Patel JR, Pati S, Pattanshetty SM, Paudel U, Pereira RB, Peres MFP, Perianayagam A, Postma MJ, Pourjafar H, Pourshams A, Prashant A, Pulakunta T, Qadir MMFF, Rabiee M, Rabiee N, Radfar A, Radhakrishnan RA, Rafiee A, Rafiei A, Rafiei S, Rahim F, Rahimzadeh S, Rahman M, Rahman MA, Rahmani AM, Rajesh A, Ramezani-Doroh V, Ranabhat K, Ranasinghe P, Rao CR, Rao SJ, Rashedi S, Rashidi M, Rashidi MM, Rath GK, Rawaf DL, Rawaf S, Rawal L, Rawassizadeh R, Razeghinia MS, Regasa MT, Renzaho AMN, Rezaei M, Rezaei N, Rezaei N, Rezaeian M, Rezapour A, Rezazadeh-Khadem S, Riad A, Rios Lopez LE, Rodriguez JAB, Ronfani L, Roshandel G, Rwegerera GM, Saber-Ayad MM, Sabour S, Saddik B, Sadeghi E, Sadeghian S, Saeed U, Sahebkar A, Saif-Ur-Rahman KM, Sajadi SM, Salahi S, Salehi S, Salem MR, Salimzadeh H, Samy AM, Sanabria J, Sanmarchi F, Sarveazad A, Sathian B, Sawhney M, Sawyer SM, Saylan M, Schneider IJC, Seidu AA, Šekerija M, Sendo EG, Sepanlou SG, Seylani A, Seyoum K, Sha F, Shafaat O, Shaikh MA, Shamsoddin E, Shannawaz M, Sharma R, Sheikhbahaei S, Shetty A, Shetty BSK, Shetty PH, Shin JI, Shirkoohi R, Shivakumar KM, Shobeiri P, Siabani S, Sibhat MM, Siddappa Malleshappa SK, Sidemo NB, Silva DAS, Silva Julian G, Singh AD, Singh JA, Singh JK, Singh S, Sinke AH, Sintayehu Y, Skryabin VY, Skryabina AA, Smith L, Sofi-Mahmudi A, Soltani-Zangbar MS, Song S, Spurlock EE, Steiropoulos P, Straif K, Subedi R, Sufiyan MB, Suliankatchi Abdulkader R, Sultana S, Szerencsés V, Szócska M, Tabaeian SP, Tabarés-Seisdedos R, Tabary M, Tabuchi T, Tadbiri H, Taheri M, Taherkhani A, Takahashi K, Tampa M, Tan KK, Tat VY, Tavakoli A, Tbakhi A, Tehrani-Banihashemi A, Temsah MH, Tesfay FH, Tesfaye B, Thakur JS, Thapar R, Thavamani A, Thiyagarajan A, Thomas N, Tobe-Gai R, Togtmol M, Tohidast SA, Tohidinik HR, Tolani MA, Tollosa DN, Touvier M, Tovani-Palone MR, Traini E, Tran BX, Tran MTN, Tripathy JP, Tusa BS, Ukke GG, Ullah I, Ullah S, Umapathi KK, Unnikrishnan B, Upadhyay E, Ushula TW, Vacante M, Valadan Tahbaz S, Varthya SB, Veroux M, Villeneuve PJ, Violante FS, Vlassov V, Vu GT, Waheed Y, Wang N, Ward P, Weldesenbet AB, Wen YF, Westerman R, Winkler AS, Wubishet BL, Xu S, Yahyazadeh Jabbari SH, Yang L, Yaya S, Yazdi-Feyzabadi V, Yazie TS, Yehualashet SS, Yeshaneh A, Yeshaw Y, Yirdaw BW, Yonemoto N, Younis MZ, Yousefi Z, Yu C, Yunusa I, Zadnik V, Zahir M, Zahirian Moghadam T, Zamani M, Zamanian M, Zandian H, Zare F, Zastrozhin MS, Zastrozhina A, Zhang J, Zhang ZJ, Ziapour A, Zoladl M, Murray CJL, Fitzmaurice C, Bleyer A, Bhakta N. The global burden of adolescent and young adult cancer in 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Oncol 2022; 23:27-52. [PMID: 34871551 PMCID: PMC8716339 DOI: 10.1016/s1470-2045(21)00581-7] [Citation(s) in RCA: 87] [Impact Index Per Article: 43.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15-39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. METHODS Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15-39 years to define adolescents and young adults. FINDINGS There were 1·19 million (95% UI 1·11-1·28) incident cancer cases and 396 000 (370 000-425 000) deaths due to cancer among people aged 15-39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59·6 [54·5-65·7] per 100 000 person-years) and high-middle SDI countries (53·2 [48·8-57·9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14·2 [12·9-15·6] per 100 000 person-years) and middle SDI (13·6 [12·6-14·8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23·5 million (21·9-25·2) DALYs to the global burden of disease, of which 2·7% (1·9-3·6) came from YLDs and 97·3% (96·4-98·1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. INTERPRETATION Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. FUNDING Bill & Melinda Gates Foundation, American Lebanese Syrian Associated Charities, St Baldrick's Foundation, and the National Cancer Institute.
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Ferrari A, Quarello P, Mascarin M, Luigi Banna G, Toss A, Sironi G, Zecca M, Cinieri S, Alessandro Peccatori F. Italian pediatric and adult oncology communities join forces for a national project dedicated to adolescents and young adults with cancer. TUMORI JOURNAL 2021; 108:104-110. [PMID: 34841968 DOI: 10.1177/03008916211058790] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Adolescents and young adults with cancer have substantially different clinical and psychological needs compared to those of pediatric patients and of older adult patients. We describe the development of an Italian national project dedicated to adolescents and young adults with cancer.
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Affiliation(s)
- Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Paola Quarello
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children's Hospital, Azienda Ospedaliera-Universitaria Città della Salute e della Scienza, Torino, University of Torino, Italy
| | - Maurizio Mascarin
- AYA and Pediatric Radiotherapy Unit, Centro di Riferimento Oncologico, Aviano, Italy
| | - Giuseppe Luigi Banna
- Interdisciplinary Group for Translational Research and Clinical Trials, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy
| | - Angela Toss
- Department of Oncology and Hematology, Azienda Ospedaliero-Universitaria di Modena, Italy
| | - Giovanna Sironi
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Marco Zecca
- Pediatric Hematology/Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Saverio Cinieri
- Medical Oncology Unit and Breast Unit, Ospedale Perrino ASL Brindisi, Italy
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Diaz RL, Moss SJ, Amin KB, Harper AS, Henning JW, Logie N, Schulte F, McKillop SJ, Lang MJ, Fidler-Benaoudia MM. Data Resource Profile: The Alberta Adolescent and Young Adult Cancer Survivor Study. Int J Epidemiol 2021; 51:e55-e64. [PMID: 34635912 DOI: 10.1093/ije/dyab193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 08/24/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ruth L Diaz
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
| | - Stephana J Moss
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Khalid B Amin
- Department of Surveillance and Reporting, Cancer Research and Analytics, Cancer Care Alberta, Alberta Health Services, Edmonton, AB, Canada
| | - Andrew S Harper
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
| | - Jan-Willem Henning
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Natalie Logie
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Fiona Schulte
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Hematology, Oncology and Transplant Program, Alberta Children's Hospital, Calgary, AB, Canada
| | - Sarah J McKillop
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Michael J Lang
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Miranda M Fidler-Benaoudia
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Trama A, Tittarelli A, Barigelletti G, Botta L, Gatta G, Tagliabue G, Contiero P, Guzzinati S, Andreano A, Manneschi G, Falcini F, Castaing M, Filiberti RA, Gasparotti C, Cirilli C, Mazzucco W, Mangone L, Iacovacci S, Vitale MF, Stracci F, Piffer S, Tumino R, Carone S, Sampietro G, Melcarne A, Ballotari P, Boschetti L, Pisani S, Cavalieri D'Oro L, Cuccaro F, D'Argenzio A, D'Orsi G, Fanetti AC, Ardizzone A, Candela G, Savoia F, Pascucci C, Castelli M, Storchi C, Bernasconi A. Excess risk of subsequent malignant neoplasms in adolescent and young adult cancer survivors: Results from the first Italian population-based cohort. Cancer 2021; 128:364-372. [PMID: 34582036 DOI: 10.1002/cncr.33931] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 07/15/2021] [Accepted: 08/03/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Evidence about late effects in adolescent and young adult (AYA) cancer survivors is scarce. This study assessed the risk of subsequent malignant neoplasms (SMNs) to identify the most common SMNs to be considered in follow-up care. METHODS Population-based cancer registries retrospectively identified first primary tumors (between 1976 and 2013) and SMNs in AYAs (15-39 years old at their cancer diagnosis). AYA cancer survivors were those alive at least 5 years after their first cancer diagnosis. The excess risk of SMNs was measured as standardized incidence ratios (SIRs) and absolute excess risk together with the cumulative incidence of SMNs. RESULTS The cohort included 67,692 AYA cancer survivors. The excess risk of developing any SMN (SIR, 1.6; 95% confidence interval, 1.5-1.7) was 60%. The excess risk of SMNs was significantly high for survivors of lymphomas; cancers of the breast, thyroid, female genital tract, digestive organs, gonads, and urinary tract; and melanomas. The cumulative incidence of all SMNs in AYA cancer survivors within 25 years of their first cancer diagnosis was approximately 10%. Subsequent tumors contributing to approximately 60% of all SMNs were breast cancer, colorectal cancer, corpus uteri cancer, and ovarian cancer in females and colorectal cancer, bladder cancer, prostate cancer, lung cancer, and lymphomas in males. CONCLUSIONS These results highlight the need to personalize follow-up strategies for AYA cancer survivors.
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Affiliation(s)
- Annalisa Trama
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Andrea Tittarelli
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Giulio Barigelletti
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Laura Botta
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Gemma Gatta
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Giovanna Tagliabue
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Paolo Contiero
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | | | - Anita Andreano
- Epidemiology Unit, Agency for Health Protection of Milan, Milano, Italy
| | - Gianfranco Manneschi
- Clinical Epidemiology Unit, Istituto per lo Studio, la Prevenzione e la Rete Oncologica, Firenze, Italy
| | - Fabio Falcini
- Department of Clinical and Experimental Oncology and Ematology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Marine Castaing
- Department of Hygiene and Public Health, Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, Università di Catania, Catania, Italy
| | - Rosa A Filiberti
- Liguria Cancer Registry, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Cinzia Gasparotti
- Epidemiology Unit, Agency for Health Protection of Brescia, Brescia, Italy
| | - Claudia Cirilli
- Modena Cancer Registry, Azienda Unità Sanitaria Locale Modena, Modena, Italy
| | - Walter Mazzucco
- Department of Medicine and Surgery, Università degli Studi di Palermo, Palermo, Italy
| | - Lucia Mangone
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Silvia Iacovacci
- Active Prevention Unit, Azienda Sanitaria Locale Latina, Latina, Italy
| | | | - Fabrizio Stracci
- Department of Experimental Medicine, Università degli Studi di Perugia, Perugia, Italy
| | - Silvano Piffer
- Evaluative and Clinical Epidemiological Service, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Unit, Azienda Sanitaria Provinciale di Ragusa, Ragusa, Italy
| | - Simona Carone
- Taranto Cancer Registry, Azienda Sanitaria Locale di Taranto, Taranto, Italy
| | - Giuseppe Sampietro
- Epidemiological Service, Agenzia di Tutela della Salute di Bergamo, Bergamo, Italy
| | - Anna Melcarne
- Cancer Registry Epidemiology Unit, Azienda Sanitaria Locale di Lecce, Lecce, Italy
| | - Paola Ballotari
- Epidemiologic Observatory, Azienda di Tutela della Salute della Val Padana, Mantova, Italy
| | - Lorenza Boschetti
- Epidemiologic Observatory, Cancer Registry, Agenzia di Tutela della Salute di Pavia, Pavia, Italy
| | - Salvatore Pisani
- Epidemiology Unit, Agenzia di Tutela della Salute dell'Insubria, Varese, Italy
| | - Luca Cavalieri D'Oro
- Epidemiology Unit, Agenzia per la Tutela della Salute della Brianza, Monza, Italy
| | - Francesco Cuccaro
- Epidemiology Unit - Cancer Registry, Azienda Sanitaria Locale di Barletta-Andria-Trani, Barletta, Italy
| | - Angelo D'Argenzio
- Epidemiology Unit, Azienda Sanitaria Locale Caserta 2, Caserta, Italy
| | - Giancarlo D'Orsi
- Department of Prevention, Azienda Sanitaria Locale Napoli 2, Napoli, Italy
| | - Anna C Fanetti
- Epidemiology Unit, Azienda di Tutela della Salute della Montagna, Sondrio, Italy
| | - Antonino Ardizzone
- Statistic and Epidemiology Unit - Cancer Registry, Azienda Sanitaria Locale di Brindisi, Brindisi, Italy
| | - Giuseppa Candela
- Cancer Registry Unit, Azienda Sanitaria Provinciale di Trapani, Trapani, Italy
| | - Fabio Savoia
- Childhood Cancer Registry of Campania Region, AORN Santobono Pausilipon, Napoli, Italy
| | - Cristiana Pascucci
- Department of Experimental Medicine and Public Health, Università di Camerino, Camerino, Italy
| | - Maurizio Castelli
- Prevention Unit, Azienda Unità Sanitaria Locale della Valle d'Aosta, Aosta, Italy
| | - Cinzia Storchi
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Alice Bernasconi
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
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Ferrari A, Stark D, Peccatori FA, Fern L, Laurence V, Gaspar N, Bozovic-Spasojevic I, Smith O, De Munter J, Derwich K, Hjorth L, van der Graaf WTA, Soanes L, Jezdic S, Blondeel A, Bielack S, Douillard JY, Mountzios G, Saloustros E. Adolescents and young adults (AYA) with cancer: a position paper from the AYA Working Group of the European Society for Medical Oncology (ESMO) and the European Society for Paediatric Oncology (SIOPE). ESMO Open 2021; 6:100096. [PMID: 33926710 PMCID: PMC8103533 DOI: 10.1016/j.esmoop.2021.100096] [Citation(s) in RCA: 100] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/23/2021] [Accepted: 02/24/2021] [Indexed: 12/17/2022] Open
Abstract
It is well recognised that adolescents and young adults (AYA) with cancer have inequitable access to oncology services that provide expert cancer care and consider their unique needs. Subsequently, survival gains in this patient population have improved only modestly compared with older adults and children with cancer. In 2015, the European Society for Medical Oncology (ESMO) and the European Society for Paediatric Oncology (SIOPE) established the joint Cancer in AYA Working Group in order to increase awareness among adult and paediatric oncology communities, enhance knowledge on specific issues in AYA and ultimately improve the standard of care for AYA with cancer across Europe. This manuscript reflects the position of this working group regarding current AYA cancer care, the challenges to be addressed and possible solutions. Key challenges include the lack of specific biological understanding of AYA cancers, the lack of access to specialised centres with age-appropriate multidisciplinary care and the lack of available clinical trials with novel therapeutics. Key recommendations include diversifying interprofessional cooperation in AYA care and specific measures to improve trial accrual, including centralising care where that is the best means to achieve trial accrual. This defines a common vision that can lead to improved outcomes for AYA with cancer in Europe.
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Affiliation(s)
- A Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
| | - D Stark
- Leeds Institute of Medical Research, School of Medicine University of Leeds, Leeds, UK.
| | - F A Peccatori
- Gynecologic Oncology Department, European Institute of Oncology IRCCS, Milan, Italy
| | - L Fern
- Department of Oncology, University College London Hospitals NHS Foundation Trust, London, UK
| | - V Laurence
- Medical Oncology Department and SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), Institut Curie, Paris, France
| | - N Gaspar
- Department of Oncology for Child and Adolescent, Gustave Roussy Cancer Campus, Villejuif, France
| | - I Bozovic-Spasojevic
- Medical Oncology Department, Institute for Oncology and Radiology of Serbia, Belgrade, Republic of Serbia
| | - O Smith
- National Children's Cancer Service, Children's Health Ireland at Crumlin and Systems Biology Ireland, University College Dublin, Dublin, Ireland
| | - J De Munter
- University Hospital Ghent Cancer Center, UZ Gent, Ghent, Belgium
| | - K Derwich
- Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, Poznan, Poland
| | - L Hjorth
- Lund University, Skane University Hospital, Department of Clinical Sciences Lund, Pediatrics, Lund, Sweden
| | - W T A van der Graaf
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - L Soanes
- Teenage Cancer Trust, London, UK
| | - S Jezdic
- Scientific and Medical Division, European Society for Medical Oncology (ESMO), Lugano, Switzerland
| | - A Blondeel
- Department of Scientific Programme Coordination, European Society for Paediatric Oncology (SIOPE), Brussels, Belgium
| | - S Bielack
- Zentrum für Kinder, Jugend und Frauenmedizin Pädiatrie 5, KlinikumStuttgart - Olgahospital, Stuttgart, Germany
| | - J-Y Douillard
- Scientific and Medical Division, European Society for Medical Oncology (ESMO), Lugano, Switzerland
| | - G Mountzios
- 2nd Department of Medical Oncology and Clinical Trial Unit, Henry Dunant Hospital, Athens, Greece
| | - E Saloustros
- Department of Oncology, University Hospital of Larissa, Larissa, Greece
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