A Snapshot of Adolescent and Young Adult Cancers
Cancers Affecting Adolescents and Young Adults (AYAs)
An estimated 67,500 adolescents and young adults (AYAs) ages 15-39 were diagnosed with cancer in 2010.1 This is almost six times the number of cases diagnosed in children ages 0-14. The incidence of specific cancer types varies dramatically across the AYA age continuum. For example, leukemia, lymphoma, and testicular cancer (germ cell tumors) are the most common cancer types in younger AYAs (15-24 years old). By ages 25-39, breast, cervical and uterine, and colorectal cancers comprise a growing share of cancers among AYAs.2 See Cancers in Young People to learn more.
Incidence, Mortality, and Survival
Cancer is the leading cause of disease-related death in the AYA population; among females, it is the most common disease-related cause of death, and among males it is second only to heart disease.3 In the AYA age group, only accidents, suicide, and homicide claim more lives than cancer.
Incidence rates of cancers in AYAs vary by race and ethnicity. Rates of both cancer incidence and 5-year survival are highest among white AYAs. American Indian/Alaska Native AYAs have the lowest cancer incidence rates. African Americans have intermediate incidence rates and the lowest 5-year survival rates.
Unlike improvements seen in younger and older age groups, survival rates for young people (AYAs) with some types of cancer have not improved in almost 30 years. Factors that may account for the lack of improved outcomes among AYAs include:
- Delayed diagnosis
- Limited understanding of the biology and etiology of the cancers in this population of the cancers in this population
- Low access to and participation in clinical trials
- Unique psychosocial and supportive care needs.
Examples of NCI Activities Relevant to AYA Cancers
- The Center for Cancer Research’s Pediatric Oncology Branch (POB) aims to improve outcomes for children and AYAs with cancer. The branch conducts basic science and clinical research on a variety of AYA-relevant cancers. Select POB clinical trials include:
- A Phase I Study of NK Cell Infusion Following Allogeneic Peripheral Blood Stem Cell Transplantation From Related or Matched Unrelated Donors in Pediatric Patients With Solid Tumors and Leukemias is testing the safety and efficacy of an immunotherapeutic combination of activated natural killer (NK) cells and interleukin 15. Patients up to 35 years of age are eligible for this study
- A Pilot Study of Genetically Engineered NY-ESO-1 Specific (c259) T Cells in HLA-A2+ Patients With Synovial Sarcoma is testing the effects of chemotherapy and genetically engineered T cells on patients with metastatic and recurrent synovial sarcoma.
- Mithramycin for Children and Adults With Solid Tumors or Ewing Sarcoma is a phase I/II trial testing the safety and efficacy of the antitumor antibiotic mithramycin in AYAs with Ewing sarcoma that expresses the EWS-FLI1 fusion protein.
- The Children’s Oncology Group (COG), an NCI-supported clinical trials cooperative group, is devoted exclusively to childhood and adolescent cancer research, including clinical trials for AYAs with cancer. Select COG clinical trials include:
- Combination Chemotherapy in Treating Patients With Non-Metastatic Extracranial Ewing Sarcoma is a phase III trial testing the addition of vincristine, cyclophosphamide, and topotecan to standard chemotherapyin children and young adults with Ewing sarcoma.
- Combination Chemotherapy in Treating Young Patients With Newly Diagnosed High-Risk Acute Lymphoblastic Leukemia is a phase III trial that is studying the efficacy of combination chemotherapy regimens in treating children and AYAs with high-risk acute lymphoblastic leukemia.
- Blood Sample Markers of Reproductive Hormones in Assessing Ovarian Reserve in Younger Patients With Newly Diagnosed Lymphomas is a clinical trial assessing the effect of curative therapy for lymphoma on the fertility of female patients under age 21.
Selected Advances in AYA Cancers Research
- In a phase II trial, patients with advanced alveolar soft part sarcoma—a disease that affects AYAs primarily and for which standard anticancer therapies are not effective—showed encouraging responses to the experimental drug cediranib. Published April 2013. [PubMed Abstract]
- Increased DNA methylation in AYAs with acute lymphoblastic leukemia correlates with clinical and pathologic disease features, suggesting a potential role for DNA methylation in leukemia formation in this population. Published July 2013. [PubMed Abstract]
- Selected Adolescent and Young Adult Health Outcomes and Patient Experiences (AYA HOPE) Study advances:
- AYAs reported high levels of unmet service needs (including financial, mental health, and support group service needs), which were associated with lower health-related quality of life (HRQOL). Published April 2013. [PubMed Abstract]
- AYAs recently diagnosed with cancer have diminished physical and psychosocial HRQOL compared to similarly aged, healthy populations. Published May 2013. [PubMed Abstract]
- Social information needs—talking about cancer experiences and meeting peer survivors—were higher among AYAs who were diagnosed in their 20s, who were Hispanic, who reported high symptom burden and/or lower quality of care, and who were not in support groups. Published June 2013. [PubMed Abstract]
- See this PubMed list of selected free full-text journal articles on NCI-supported research relevant to adolescent and young adult cancers. You can also search PubMed for additional scientific articles or to complete a search tutorial.
Additional Resources for AYA Cancers
NCI Adolescents and Young Adults with Cancer Portal
Information about cancer in adolescents and young adults: treatment, clinical trials, support options, research, and other topics from the National Cancer Institute.
Focus Under Forty
A series of educational modules developed by American Society of Clinical Oncology and LIVESTRONG with input from the NCI.
NCI’s AYA YouTube Playlist
Three videos where cancer researchers, advocates, and cancer survivors discuss AYA cancers and issues relevant to AYA cancers.
Adolescents and Young Adults with Cancer: Reports, Research, and Literature
Reports and research projects that address the special challenges facing adolescents and young adults with cancer and provide details about incidence, outcomes, and survival for this population.
- 1 An estimated projection calculated by the Surveillance, Epidemiology and End Results (SEER) Program using SEER 18, 2006-2010.
- 2 Data from the SEER Program.
- 3 Total U.S. deaths in 2010, ages 15–39, from the SEER Program and the National Center for Health Statistics.