The spectrum of cancer in adolescents and young adults (AYAs): An observational study in a single institution from 2015-2019.

Abstract

e13629 Background: Cancer in adolescents and young adults (AYAOs) refers to patients diagnosed with a malignancy between 16 and 39 years old. This is thought to be 5% in the Western population. The exact incidence and distribution in Asia is uncertain although the WHO estimated 650 000 AYAs to be newly diagnosed in this part of the world in 2018. There is limited data on the incidence and epidemiology on AYAs in Asia, but it is known from the western literature that the distribution of cancer types, clinico-pathological features and outcomes in this population is very different. We therefore, sought to evaluate the pattern of cancer types among the different age groups of the AYA population seen in a high-volume single Asian tertiary cancer centre. Methods: We undertook a retrospective observational study of all patients diagnosed with cancer between 16 and 39 years old who presented to the National Cancer Centre Singapore (NCCS) from 1 January 2015 to 31 December 2019. Results: A total of 2583 cases was observed during the 5-year period. The male: female ratio was 1:1.75. The majority of the patients were between of 35-39 years (y) ( n= 1128, 44.0%). The most common cancer across the different age groups in females were sarcoma (16-19 y), hematologic malignancies (20-24 y) and breast cancer (25-29 y, 30-34 y and 35-39 y). The most common cancer across the different age groups in males were hematologic malignancies (16-19 y), germ cell tumours (20-24 y), germ cell tumours, hematologic malignancies and sarcoma (25-29 y), hematologic malignancies (30-34 y) and colorectal cancers (35-39 y). The majority of the patients presented were localized disease (38.3%), while 19.4% presented with lymphatic involvement. Amongst 507 (19.6%) patients presenting with metastatic disease, 126 patients have deceased. Conclusions: This population has unique characteristics compared to their geriatric and pediatric counterparts. With an increased incidence and expected longer survivals, more efforts are needed to better understand the clinicopathological features of the AYA population. This will enable us to better survival rates and long-term treatment outcomes.