Clin Pediatr Hematol Oncol.  2021 Apr;28(1):1-13. 10.15264/cpho.2021.28.1.1.

Management of Malignancies Developing in AYA

Affiliations
  • 1Departments of Pediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, China
  • 2Departments of Clinical Oncology, The Chinese University of Hong Kong, Prince of Wales Hospital, China
  • 3Department of Pediatrics and Adolescent Medicine, Hong Kong Children Hospital, China
  • 4Hong Kong Hub of Pediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China

Abstract

Adolescent and young adult (AYA) with cancers have distinct spectrum of cancers as compared to younger and older age groups. The definition of age limits of AYA varies among countries, from 15-25 years to 12-39 years. The differences in age definition lead to variation in report of incidence, types of cancers and survival. In younger AYA patients, hematological malignancies are leading cause of cancers. In older AYA patients, testicular cancers are common in males while breast cancers and cervical cancers are predominant types in females. There is increasing incidence of AYA cancers worldwide in the past two decades. Overall survival and treatment outcome of AYA cancer has been improving in the last few decades. Specialized centers for AYA with cancers provide more comprehensive care and have been reported to have superior outcome. About 80% of AYA with cancers survive at 5 years after diagnosis but they are higher risk of developing second malignancies. Barriers to AYA cancer treatment included social economic status, insurance system and accessibility to clinical trials. Survivors of AYA cancers are also at higher risk dying from cardiovascular diseases and respiratory diseases. Survivorship program should be in place to enhance education and surveillance.

Keyword

Adolescent; Young adult; Cancer; Outcome
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