Nav: Home

Five-year survival improves for certain cancers in adolescent and young adults

March 03, 2020

CHAPEL HILL -- The five-year survival rate for adolescents and young adults with cancer has significantly improved from 1975 to 2005 in the United States overall, but this was not the case for all cancers, according to a report in the Journal of the National Cancer Institute.

"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 Hazel B. Nichols, PhD, member of the University of North Carolina Lineberger Comprehensive Cancer Center and associate professor in the UNC Gillings School of Global Public Health.

Chelsea Anderson, PhD, MPH, postdoctoral fellow at the American Cancer Society, was the study's corresponding author.

The researchers identified substantial improvements in five-year mortality rates for adolescents and young adults (AYA) diagnosed with leukemia, non-Hodgkin lymphoma, Hodgkin lymphoma, central nervous system tumors, melanoma and other skin cancers, breast cancer or kidney cancer.

However, five-year mortality rates for AYA patients with bone tumors, soft tissue sarcomas, bladder cancer, cervical and uterine cancers or colorectal cancer did not improve across the more than 30-year time period.

Researchers compared mortality rates in the five to 10 years beyond diagnosis for people ages 15 to 39. They compared mortality rates for young people in the U.S. who were first diagnosed between 1975 and 1984 with rates for people diagnosed in more recent time periods, including from 1985-1994, 1995-2004 and 2005-2011. The study drew on data from the National Cancer Institute's Surveillance, Epidemiology and End Results database.

They found that all-cause mortality rates in the five to 10 years after diagnosis fell from 8.3 to 5.4 percent between 1975-1984 and 2005-2011. That decline was driven by a drop in the number of deaths from the patients' primary cancer, Nichols said, although deaths from other causes declined as well.

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

UNC Lineberger's Andrew B. Smitherman, MD, MSc, assistant professor and medical director of the UNC Adolescent and Young Adult Oncology Program, said the results were encouraging.

"With improved cancer-directed therapies and enhanced supportive care, survival outcomes are improving among many AYA cancers, including for leukemia, lymphoma and central nervous system cancers," Smitherman said. "Also, improvements in non-cancer mortality were observed that speak to refinements in cancer treatment to limit treatment-related late effects, such as cardiopulmonary disease. The authors also report small decreases in mortality related to secondary cancers. More time will be needed to fully understand how changes in therapy over the past few decades will impact rates of secondary cancers, as these may develop much later."

However, while mortality rates improved overall, there was no major improvement in five-year mortality rates for AYA patients with bone tumors, soft tissue sarcomas, bladder cancer, cervical and uterine cancers, or colorectal cancer.

"This highlights areas where more work needs to be done," Nichols said.

Cancers among adolescents and young adults make up only about 4 percent of all cancers diagnosed in the U.S., researchers reported. However, previous studies indicated that survival improvement has been less dramatic in this age group.

"Cancer risk is still very low overall before 40," Nichols said. "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."

To improve outcomes and provide support for adolescents and young adults, UNC Lineberger and the North Carolina Cancer Hospital launched a program for patients with cancer between the ages of 13 and 40.

The program, which is under the direction of Smitherman and Lauren Lux, LCSW, is designed to recognize that teenagers and young adults have unique cancer biology and have different needs than other patients. Cancer treatment can impact relationships, career, independence, fertility and other aspects of life.

"This study underscores the importance of clinical trials in advancing cutting-edge treatments and cures for cancer," Smitherman said. "Many of the improvements that have been seen in pediatric, adolescent and young adult cancers are due to the work of cooperative research groups. More work is needed to develop new treatments for the AYA cancers that are not seeing equivalent survival improvements. These results can help inform clinical researchers regarding where we need to focus energy to develop new trials, and hopefully improve outcomes."
Funding sources: Nichols was supported by the St. Baldrick's Foundation.

UNC Lineberger Comprehensive Cancer Center

Related Cancer Articles:

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.
Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.
Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.
Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.
More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.
New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.
American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.
Oncotarget: Cancer pioneer employs physics to approach cancer in last research article
In the cover article of Tuesday's issue of Oncotarget, James Frost, MD, PhD, Kenneth Pienta, MD, and the late Donald Coffey, Ph.D., use a theory of physical and biophysical symmetry to derive a new conceptualization of cancer.
Health indicators for newborns of breast cancer survivors may vary by cancer type
In a study published in the International Journal of Cancer, researchers from the UNC Lineberger Comprehensive Cancer Center analyzed health indicators for children born to young breast cancer survivors in North Carolina.
Few women with history of breast cancer and ovarian cancer take a recommended genetic test
More than 80 percent of women living with a history of breast or ovarian cancer at high-risk of having a gene mutation have never taken the test that can detect it.
More Cancer News and Cancer Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Clint Smith
The killing of George Floyd by a police officer has sparked massive protests nationwide. This hour, writer and scholar Clint Smith reflects on this moment, through conversation, letters, and poetry.
Now Playing: Science for the People

#562 Superbug to Bedside
By now we're all good and scared about antibiotic resistance, one of the many things coming to get us all. But there's good news, sort of. News antibiotics are coming out! How do they get tested? What does that kind of a trial look like and how does it happen? Host Bethany Brookeshire talks with Matt McCarthy, author of "Superbugs: The Race to Stop an Epidemic", about the ins and outs of testing a new antibiotic in the hospital.
Now Playing: Radiolab

Dispatch 6: Strange Times
Covid has disrupted the most basic routines of our days and nights. But in the middle of a conversation about how to fight the virus, we find a place impervious to the stalled plans and frenetic demands of the outside world. It's a very different kind of front line, where urgent work means moving slow, and time is marked out in tiny pre-planned steps. Then, on a walk through the woods, we consider how the tempo of our lives affects our minds and discover how the beats of biology shape our bodies. This episode was produced with help from Molly Webster and Tracie Hunte. Support Radiolab today at