AYAs with Certain Cancer Types Saw Improvements in 5-Year Mortality Rates

Adolescents and young adults (AYAs) with some forms of cancer saw a significant improvement in 5-year survival rates from 1975-2005, but not all cancers saw an improvement, according to a study published in the Journal of the National Cancer Institute.¹

In particular, AYAs with leukemia, non-Hodgkin lymphoma, Hodgkin lymphoma, central nervous system tumors, melanoma and other skin cancers, breast cancer or kidney cancer experienced these improvements, while those with bone tumors, soft tissue sarcomas, bladder cancer, cervical and uterine cancers, or colorectal cancer, did not.

“We are making improvements in survival for adolescents and young adults with cancer over time, but adolescents and young adults are a heterogeneous group, and we have to make sure that overall improvements don’t hide the fact that there are specific cancer types that haven’t had equivalent advances, and we need to do more,” said lead study author Hazel B. Nichols, PhD, in a press release.²

The researchers found that mortality rates in the 5-10 years after initial diagnosis dropped from 8.3% (95% CI, 8.0-8.6) to 5.4% (95% CI, 5.3-5.6) between 1975-1985 and 2005-2011, respectively. The study enrolled 282,969 cancer survivors aged 15-39 years old in which groups of patients were diagnosed between 1975-1984 and compared with the mortality rates of groups of patients diagnosed in 2005-2011.

The study utilized the Surveillance, Epidemiology, and End Results database to compile a sample of adolescents and young adults diagnosed with cancer between 1975-2011 who survived for 5 years or more after diagnosis. The data found that results were decreases in mortality rates from the primary cancer between both specific periods.

“Some of the most dramatic improvements were for leukemia and non-Hodgkin lymphoma,” Nichols said in a press release. “In those groups, we saw that if you were diagnosed with leukemia, for example, in 1975, the mortality between 5 and 10 years was almost 30%. If you were diagnosed with that same disease in 2005, the mortality rate was only 7%. That’s pretty dramatic over a 30-year interval.”

Nichols stressed the next steps in the field surrounds work on the cancer types that did not see significant improvements in 5-year mortality rates. While adolescents and young adults only make up 4% of all cancer diagnoses in the United States, previous research suggests overall survival improvements are less substantial in this demographic group.

“Cancer risk is still very low overall before 40,” Nichols said in a press release. “However, we haven’t seen strong representation of adolescents and young adults in clinical trials, which may be contributing to the fact that patients with certain cancer types in this age group haven’t made big advancements over this time period.”

References:

1. Anderson C, Nichols HB. Trends in late mortality among adolescent and young adult (AYA) cancer survivors. Journal of the National Cancer Institute. https://doi.org/10.1093/jnci/djaa014.

2. Five-year survival improves for certain cancers in adolescent and young adults [news release]. Published March 3, 2020. https://unclineberger.org/news/five-year-survival-improves-for-certain-cancers-adolescent-and-young-adults/. Accessed March 9, 2020.