Clinical practice guidelines for adolescent and young adult cancer: A literature review.

Abstract

e13727 Background: Cancers among adolescents and young adults (AYA, aged 15-39) are rising in incidence, yet formal guidelines for diagnosis, treatment, and management of AYA-specific cancers are not widely known or disseminated. Practice patterns vary widely, contributing to a lack of improvement in outcomes for this underserved population. Clinicians and health systems have reported a need for additional guidance in care delivery for AYAs. Methods: We conducted a comprehensive literature review to identify clinical practice guidelines for cancer care delivery specific to AYAs published in PubMed or MEDLINE since 2010. MeSH and other key words were applied, using a search strategy guided by a health science librarian (EM). 795 papers were identified, with 690 excluded based on title and abstract review. 105 papers underwent full text review, and 64 papers underwent complete data extraction. Using Covidence software, two team members independently reviewed articles at the data extraction phase, with disagreements resolved through discussion. Results: We identified 22 papers that met our inclusion criteria as clinical practice guidelines specific to AYA cancer care. Clinical focus included breast cancer (4), sarcoma (4), brain tumors (2), gynecologic malignancies (2), acute lymphoblastic leukemia (1), colorectal cancer (1), NUT carcinoma (1), and proton therapy (1). Six papers covered general principles of caring for AYAs, regardless of cancer diagnosis. Key themes across guidelines included the importance of fertility preservation and psychosocial support, multidisciplinary care provided at specialized centers, and consideration of long-term toxicities of treatment. Conclusions: Clinical practice guidelines exist to inform clinicians and health systems on best practices for caring for AYAs with cancer, a growing and underserved population. Further dissemination of these guidelines may assist with improving outcomes. Comprehensive summary of these and other AYA specific guidelines is forthcoming and may serve as a useful clinical reference. [Table: see text]