Survival outcomes have not improved over the past few decades for adolescents and young adults (AYAs) with female breast cancer, certain gynecologic cancers, and sarcomas, according to research published in Cancer.

The researchers noted that an estimated 89,500 AYA patients (ages 15 to 39 years) were diagnosed with cancer in the United States in 2020, and more than 9000 AYA cancer patients are projected to die each year. However, survival outcomes differ by cancer type.

For this population-based study, the researchers evaluated survival outcomes among AYA patients diagnosed with cancer between 1975 and 2016 to determine changes in survival rates with particular cancer types. Data from the Surveillance, Epidemiology, and End Results 18 (SEER-18) registry and the National Cancer for Health Statistics were used.

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During 2012-2016, the cancer incidence rate in the AYA population was 74.96 per 100,000 individuals, and the cancer mortality rate was 9.01 per 100,000 individuals.

Over the entire period studied, 5-year relative survival (RS) improvements were noted in brain and nervous system cancers, colorectal cancers, lung and bronchus cancer, acute myeloid leukemia, and non-Hodgkin lymphoma (P <.05 for all).

On the other hand, the researchers found “limited or no improvement” in 5-year RS rates among patients with female breast cancer, cervical cancer, ovarian cancer, and bone and joint sarcoma.

The researchers noted that 5-year RS rates improved in patients with colorectal cancer, but the overall mortality and disease incidence increased over the study period. The disease incidence increased at a 3-fold higher rate compared with mortality.

“Substantial concern remains regarding the high number of breast cancers coupled with declining survival rates, the increases in colorectal cancer incidence, and the slow progress for sarcomas and AML [acute myeloid leukemia], which suggest investigations of biological differences among AYA patients and efforts to further improve treatment in this group [are needed],” the researchers wrote.


Lewis DR, Siembida EJ, Seibel NL, Smith AW, Mariotto AB. Survival outcomes for cancer types with the highest death rates for adolescents and young adults, 1975-2016. Cancer. Published online July 26, 2021. doi:10.1002/cncr.33793