Did You Know... The Facts About Young Adults and Cancer?
The Abramson Cancer Center of the University of Pennsylvania Last Modified: March 14, 2012
Young adults (YA) are defined as those people between the ages of 15 and 39.
About 70,000 YAs are diagnosed with cancer each year, with an estimated 1 million survivors of cancer in young adulthood.
This incidence makes a cancer diagnosis 8 times more common in YAs than in kids under 15 years of age. Yet YAs have gotten little attention from the medical community.
Cancer survival rates in YAs have not changed in 30 years. Why is this, when other age groups have seen improvements in survival? Some of the possible reasons include:
This age group has the highest uninsured or underinsured rates of any age group in the U.S., which may lead to delayed diagnosis and healthcare.
YAs may see themselves as not at risk for serious disease and thus delay seeking medical attention. Many do not have a primary healthcare provider and don't know where to go when symptoms present.
Healthcare providers see YAs as low risk for cancer and may not consider this diagnosis. Symptoms may be attributed to stress or fatigue related to school, work, or family obligations.
Many YAs are not referred to comprehensive cancer centers for treatment, limiting the participation of this age group in clinical studies.
Non-Hispanic whites have the highest incidence of cancer among YAs, but also have the highest 5-year survival rates. African- Americans are in the middle as far as incidence rates, but have the lowest 5-year survival of YAs across all cancer diagnoses.
The type of cancer diagnosed varies, depending on age. In 15-19 year-olds, lymphoma, germ cell tumors (testicular cancer) and leukemia are the most common diagnoses. In 20-39 year- olds, carcinomas (such as breast & colon cancer) are the most common diagnoses.
Researchers believe that certain cancers in YAs may be biologically different than in other age groups. For instance, a breast cancer in a 30 year-old woman is probably very different from the same diagnosis in a 70 year-old. But, research is required to determine these differences and how they should affect treatment in YAs.
More than 60% of patients under 15 years of age are treated on a clinical trial, which has led to dramatic improvements in childhood cancer survival. In contrast, only 10% of 15-19 year- olds and 1-2% of 20-39 year-olds with a cancer diagnosis participate in a clinical trial.
YAs have concerns that present unique challenges to this group, such as fertility concerns, body image, cognitive function, late treatment effects, and issues related to education, employment, and insurance.
The number 1 psychosocial issue for YAs is social isolation. Friends and family often don't know what to do for them, nor can they understand the effect it has on the YA. This may lead to social withdrawal on the part of the patient and/or friends and family.
Unfortunately, many oncology offices do not have the knowledge or support staff to provide the needed support for YAs. Lack of referral to research institutions has resulted in a lack of research into the specific needs for this group.
After treatment, YAs are more often lost to follow up, given their high geographic mobility and insurance issues, further compounding the lack of knowledge of late treatment effects in this group.
Researchers have found that all cancer survivors have a 14% higher risk of developing a second cancer compared to the general population. Children and YA's are at the highest risk for developing second cancers, most likely related to exposure to treatments that can cure cancers but also cause mutations that lead to second cancers (i.e. chemotherapy and radiation therapy).
What is being done to support YAs?
Numerous private groups have stepped up to offer support to YAs (see support resources below).
National Young Adult Cancer Awareness Week occurs every year in early April.