Biology, epidemiology, and clinical outcomes affecting adolescent and young adult patients are usually different than those of younger and older patients with cancer.
AYA is a branch of medicine that deals with the prevention, diagnosis, and treatment of cancer in AYA patients aged 13-30.
In 2020 the incidence of cancer in the US in the AYA population was estimated to be 89,500 with 9270 cancer deaths.
Globally up to 1.19 million cancers cases are estimated to be diagnosed in AYA patients annually. compared with children less than 15 years.
Five-year survival in AYA patients is worse for those with ALL, AML, Hodgkin’s lymphoma, non-Hodgkin’s lymphoma, astrocytomas, Ewing, sarcoma, rhabdomyosarcoma, or osteosarcoma.
Five year relative survival is better in AYA patients with Medulloblastomas and germ cell tumors compared with children with these tumors, suggesting biological differences in the tumors of each age group.
Compared with adults, 40 years of older AYA patients have better survival, except for breast the colorectal cancers increasing age is associated with poor prognosis, and AYA patients with AML, NHL, Burkitt-like lymphoma or rhabdomyosarcoma.
Genetic, physiological, and pharmacologic changes associated with adolescent and young adult patients may impact our ability to tolerate cancer therapy and their response to treatment.
Short and long-term toxicities impacting a young patient, including the impact of treatment on fertility, may be a disincentive to treatment, and lead to gaps adherence and poor outcomes.
Adolescent and young adults patients is defined as an individual 15-39 years of age at the time of initial cancer diagnosis.
Adolescent and young adults with cancer fate worse than their younger or older counterparts in terms of survival outcomes and clinical trial enrollment.
AYAs are at a complicated time of social, emotional, and cognitive development.
Nearly 86,000 AYA’s are diagnosed annually in the US.
The survival rate for adolescents and young adults has remained stagnant.
Almost 70,000 people in this age range are diagnosed with cancer each year in the US, which is more than seven times more than people who are diagnosed younger than 15 years of age.
Compared with children younger than 15 years, the five-year relative survival for adolescents/young adult patients is worse for acute lymphoblastic leukemia, accute myelogenous leukemia, Hodgkin’s disease, Astrocytoma‘s, non-Hodgkin’s lymphoma, Ewing sarcoma, rhabdomyosarcoma, or osteosarcoma.
The five-year relative survival is better in adolescents and young adults with a medulloblastoma and germ cell tumors compared with children with these tumors.
Compared with adults 40 years and older, adolescent/young adult patients tend to have better survival rates, except for breast and prostate cancer.
Increasing age is associated with poorer prognosis in adolescent/young adults patients with acute myelogenous leukemia, non-Hodgkin lymphoma, Burkitt, and Burkitt-like lymphoma or rhabdomyosarcoma.
The spectrum of cancer types that affect the AYA population is different from those that affect the pediatric and older populations.
Thyroid cancers, lymphomas, melanomas, testicular cancer, cervical cancer, bone and soft tissue, sarcomas, leukemias, CNS cancers, breast cancer, and colorectal cancer cancer account for the majority of cancers in this age group.
Adolescent and young adult cancer survivors have a 73% higher risk for endocrine diseases than the cancer-free population,
Germ cell tumors exhibit a bi distribution: the first peak in young children ages 0-4 years and the second peak observed beginning at age 9 years in girls and 11 years in boys.