Survival rates among AYAs with certain cancers show little or no improvement

Although 5-year survival rates increased for several types of cancer in adolescents and young adults, little or no improvement was seen for some common malignancies in this population, according to results published in Cancer.

NCI investigators called for a targeted response and more research to address this latest trend, most apparent with breast cancer, gynecologic cancers and sarcomas.

“As the collection of SEER cancer data expands over time, including more years of diagnosis, we are able to piece together more of the cancer survival story for the teenager and young adult [AYA] population in the United States’, Denise Riedel Lewis, PhD, MPH, Chairman of the SEER Rapid Response Surveillance Studies Committee in the Cancer Control and Population Sciences division at NCI, said in a press release. “These results will allow us to refocus our research efforts on [AYA] cancer survival.

Lewis and his colleagues used data from the SEER database and the National Center for Health Statistics to analyze incidence, mortality, and survival rates from 1975 to 2016 for nine types of cancer with the highest death rates. raised among AYAs aged 15 to 39. The researchers modeled relative survival trends using JPSurv, a new Joinpoint regression program designed specifically for survival data.

Results showed significant improvement in 5-year relative survival for brain tumors and other tumors of the nervous system, colon and rectal cancer, lung and bronchial cancer, acute myeloid leukemia, and non-Hodgkin lymphoma. . Researchers attributed the advances in these cancers to new prevention options, advances in diagnosis and treatment, and control of risk factors such as HIV / AIDS and HPV, among other factors.

However, Lewis and his colleagues found little or no improvement in survival for female breast cancer, cervical cancer, ovarian cancer, and bone and joint sarcomas.

Survival rates plateaued among AYAs with female breast cancer, who had the highest incidence and mortality rates among this population. The results of the trend analysis showed that 5-year relative survival increased from 1985 to 2007, by an annual rate of 0.66 percentage points, and stabilized after 2007. Although mortality increased decreased from 1986 to 2012, it has increased since 2012.

Among AYAs with cervical cancer, the 5-year relative survival rate exceeded 80% in 1975 and was maintained until 2011. The disease burden decreased after 2005 due to the declining incidence and a stable mortality rate.

The five-year relative survival for ovarian cancer increased slightly – by 0.24 percentage points – over the period analyzed, with the incidence remaining stable since 1996 after large declines in 1993 and 1996. Mortality has also declined.

For sarcomas of the bones, joints and soft tissues, the 5-year relative survival increased by 0.82 percentage points from 1975 to 1989 before stabilizing. The increase in incidence between 1975 and 2016 and a stable death rate indicated an increased burden of disease, wrote Lewis and colleagues.

More research is needed in cancers that have shown little or no improvement, according to the researchers.

“Significant concerns remain about the high number of breast cancers associated with declining survival rates, increased incidence of colorectal cancer and slow progress in sarcomas and AML, suggesting research into the biological differences between AYA patients and efforts to further improve treatment in this area. group, ”they wrote.