Teenagers’ and young adults’ cancers diagnosis and treatment statistics

Routes to diagnosis

'Two-week wait' is the most common route to diagnosing teenagers’ and young adults’ cancers

Surgery

Common treatment for teenagers’ and young adults’ cancers, UK

Chemotherapy

Common treatment for teenagers’ and young adults’ cancers, UK

Radiotherapy

Common treatment for teenagers’ and young adults’ cancers, UK

Around a fifth (19%) of cancer cases in teenagers and young adults in England are diagnosed via the ‘two-week wait’ referral route.[1]

Almost a quarter (23%) of cancer cases in teenagers and young adults in England are diagnosed following a routine or urgent GP referral (but not under the ‘two-week wait’ referral route.[1]

Around a quarter (24%) of cancer cases in teenagers and young adults in England are diagnosed after presenting as an emergency.[1]

As for adults route of diagnosis varies considerably by cancer type. 

References

  1. Routes to diagnosis data were provided by National Cancer Intelligence Network, on request October 2012. Similar data can be found here: http://www.ncin.org.uk/publications/routes_to_diagnosis.aspx
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Treatments for most cancers in teenagers and young adults are surgery, chemotherapy Open a glossary item, and radiotherapy Open a glossary item and combinations of any or all of these.

Treatment summary for selected cancers in teenagers and young adults

Cancer Treatment
Lymphomas Hodgkin lymphoma The main treatments are chemotherapy (sometimes in combination with steroids) and radiotherapy. Occasionally surgery is used for nodular lymphocyte-predominant Hodgkin lymphoma, a particularly indolent form of the disease. Stem cell transplants (including bone marrow transplants) are sometimes used for relapsed disease.
Non-Hodgkin lymphoma (NHL)
Carcinomas Although carcinomas together make up the second most common diagnostic group in 15-24 year-olds, they comprise a diverse group of cancer types with a wide range of prognoses. Treatment is dependent on where the primary tumour is located, how aggressive it is, whether it can be surgically removed and whether it has spread to other organs. However, in general, surgery is used for good prognosis tumours, frequently in combination with radiotherapy or chemotherapy. For poor prognosis tumours, treatment may be limited to radiotherapy and/or chemotherapy.
Germ cell tumours (GCTs) For extra-cranial GCTs (those occurring outside of the brain), the main treatments are surgery and chemotherapy. For intra-cranial GCTs, combinations of chemotherapy, radiotherapy and surgery are used depending on the type.
Brain, other central nervous system (CNS) and intracranial tumours Teenagers and young adults can develop a wide range of different types of brain, other CNS and intracranial tumours. In general, surgery is used to remove as much of the tumour as possible. Depending on the type, radiotherapy and/or chemotherapy may also be used. If surgery is not possible, radiotherapy and chemotherapy may be used alone or in combination.
Malignant melanoma Early or medium-stage melanoma is treated with surgery to remove the lesion (stage 1 and 2) and affected lymph nodes (stage 3). Treatment for metastatic melanoma can include surgery, radiotherapy, chemotherapy and biological therapies.
Leukaemia Acute lymphoid leukaemia (ALL) Chemotherapy is the main treatment, usually in combination with steroids. Chemotherapy is usually carried out in three phases: remission induction, consolidation, and maintenance. Stem cell transplants (including bone marrow transplants) and biological therapies may be used. Occasionally treatment also involves radiotherapy, either to the brain or to the whole body. Relapsed ALL is usually treated with a combination of chemotherapy and stem cell transplant.
Acute myeloid leukaemia (AML) Chemotherapy is the main treatment. Stem cell transplants (including bone marrow transplants) and biological therapies may be used. Occasionally treatment also involves radiotherapy either to the brain or to the whole body. Relapsed AML is usually treated with a combination of chemotherapy and stem cell transplant.
Chronic myeloid leukaemia (CML) Treatment is mainly with biological therapies. Sometimes chemotherapy and/or stem cell transplants (including bone marrow transplants) are used.
Bone tumours A combination of chemotherapy and surgery is usually used. Radiotherapy may also be used, either instead of surgery or in addition to it, particularly for Ewing tumour. Surgery may involve removal of the tumour and some normal tissue around it, or sometimes removal of a whole limb (amputation).
Soft tissue sarcomas (STSs) Surgery is usually the main treatment for the primary tumour. Radiotherapy may also be used, either before or after surgery. Some types of STS, such as rhabdomyosarcoma, are also treated with chemotherapy. If the tumour cannot be resected, or if it has spread to other organs, radiotherapy or chemotherapy may be used on their own or in combination.

References

  1. Data were provided by Catherine O'Hara and Debasree Purkayastha, North West Cancer Intelligence Service on behalf of the National Cancer Intelligence Network (NCIN); Professor Jillian Birch and Robert Alston, Cancer Research UK Paediatric and Familial Cancer Research Group (University of Manchester), Dr Martin McCabe (University of Manchester), and Charles Stiller, Childhood Cancer Research Group (University of Oxford), on request 2013.
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Teenage and young adult patients are generally more able to tolerate intensive therapies and surgery than older adults, as they are less likely to have other medical problems and their organs are usually healthy.[1However, historically, there have been marked differences in treatment approaches between paediatric and adult oncologists in treating some of the major cancers seen in teenagers and young adults, with treatment being based on age rather than disease type. This makes the impact of therapy on survival outcomes difficult interpretation. Some studies suggest that treating teenagers and young adults according to ‘paediatric’ protocols rather than ‘adult’ protocols are associated with better survival, for some cancers (Acute lymphoblastic lymphoma, Ewing sarcoma and rhabdomyosarcoma).[2-4] However, there this association is not found for other cancers (acute myeloid leukaemia, Hodgkin lymphoma or NHL).[1]

References

  1. Coccia PF, Altman J, Bhatia S, et al. Adolescent and young adult oncology. J Natl Compr Canc Netw 2012;10:1112-50.
  2. Ram R, Wolach O, Vidal L, et al. Adolescents and young adults with acute lymphoblastic leukemia have a better outcome when treated with pediatric-inspired regimens: systematic review and meta-analysis. Am J Hematol 2012;87:472-8.
  3. Scurr M, Judson I. How to treat the Ewing's family of sarcomas in adult patients. Oncologist 2006;11:65-72.
  4. Ferrari A, Dileo P, Casanova M, et al. Rhabdomyosarcoma in adults. A retrospective analysis of 171 patients treated at a single institution. Cancer 2003;98:571-80.
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Cancer Statistics Explained

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