Cancer in the adolescent and young adult (AYA) population in the United States: Current statistics and projections.

Abstract

6072 Background: The AYA, defined as people between ages 15 and 40 years, is projected to increase from approximately 104 million in 2000 to 115 million in 2030. Even though cancer is the leading disease-related cause of death, AYA remains a relatively understudied area in oncology. We assessed the current and projected cancer burden in this population. Methods: We obtained data from the SEER program. We excluded benign tumors, myeloproliferative and myelodysplastic neoplasms, as well as in situ cervical tumors. Incidence was reported per 1,000,000 person-years and age-adjusted to the 2000 US standard population. For current statistics, we used 2003-2007 data, while for trend analyses we used 1973-2007 data unless otherwise stated. Results: Currently, the AYA represent approximately 5.3% of annual new cancer cases diagnosed (86,285) and 2.1% of cancer deaths (9,207) in the US. The 10 leading cancers by incidence (both sexes combined) are breast (115.7), melanoma (103.1), thyroid (81.1), testicular (51.7), non-Hodgkin lymphoma (NHL) (39.7), Hodgkin lymphoma (36.8), central nervous system (CNS) (34.1), colorectal (33.9), cervical (32.0), and leukemia (29.9). The incidences are increasing overall and among the top 10 cancers for thyroid, CNS, testicular, breast, melanoma, and colorectal cancers; decreasing for cervical cancer; and relatively stable for NHL, Hodgkin lymphoma, and leukemia. The 10 leading causes of cancer deaths are breast (12.2%), leukemia (12.1%), CNS (9.1%), colorectal (8.0%), lung (6.3%), NHL (5.7%), cervical (4.8%), sarcoma (4.2%), stomach (4.1%), and melanoma (3.5%). Five-year cancer specific survival rates have been increasing for most cancers except for thyroid and cervical, in which the rates remain stable. If more recent trends continue, the AYA is expected to represent 3.4% of annual new cancer cases diagnosed and 1.2% of cancer deaths by 2030. Conclusions: The AYA have distinct cancer incidences and mortality rates. While the proportions of annual new cancer cases and cancer deaths in AYA are expected to decline relative to the other age groups, the cancer burden is anticipated to increase due to projected growth of the US population and an increasing overall incidence.