Cancer survival in European adolescents and young adults


      Survival of patients aged 15–24 years, diagnosed with cancer during the period of 1990–1994, is described within Europe. Data on 15 101 patients, extracted from the files of the 56 adult cancer registries included in the EUROCARE-3 database, representing 20 European countries, were analysed and compared. Five-year survival for ‘all cancers combined’ was 75% in males (ranging from 59% in Estonia to 89% in Iceland), and 78% in females (ranging from 59% in Estonia to 89% in Norway). The Northern European countries (except Denmark) and Austria had the highest survival figures, while survival in the Eastern European countries was lower than the European average. Denmark, UK, and the pool of the central European countries, had intermediate survival figures. Haemopoietic tumours were the most common malignancies: 5-year survival was high for Hodgkin's disease (89%), intermediate for non-Hodgkin's lymphoma (68%) and lower for acute lymphoblastic leukaemia (ALL) (47%) and acute myeloblastic leukaemia (AML) (39%). Five-year survival for gonadal germ cell cancers, the second most common malignancy in young adults, was 90%. Five-year survival for the other cancers under consideration was as follows: 89% for skin melanoma, 66% for all Central Nervous System (CNS) tumours, 57% for bone tumours, 58% for osteosarcoma, 42% for Ewing's sarcoma, 57% for soft-tissue sarcomas, 99% for thyroid carcinoma, 82% for uterine cervical carcinoma, and 83% for ovarian carcinoma. For more ‘adult-specific tumours’, 5-year survival was good for colon (77%) and lung (60%) cancers, and less favourable, compared with adults, for breast cancer (68%). Adolescents (15–19 years) had significantly worse survival than young adults (20–24 years) for all malignancies combined. Survival for Hodgkin's lymphoma, CNS tumours, melanoma and colon cancer showed marked regional variability. Since many of the tumours occurring in young adults are curable, these results should encourage, without delay, efforts to identify obstacles to improving outcome and reducing geographical inequalities in survival for this group of patients.


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      1. Parkin D.M. Whelan S.L. Ferlay J. Teppo L. Thomas D.B. Cancer Incidence in Five Continents. Scientific Publications 2002, Vol. VIII, No. 155. IARC, Lyon2002
        • Stiller C.
        Overview Epidemiology of cancer in adolescents.
        Med. Pediatr. Oncol. 2002; 39: 149-155
        • Smith M.
        • Gurney J.
        • Ries G.L.A.
        Cancer among adolescents 15–19 years old.
        in: Ries L.A. Smith M.A. Gurney J. Cancer Incidence and Survival Among Children and Adolescents: United States SEER Program. NIH Pub. No. 99-4649. NIH, Bethesda1999: 79-90
        • Cotterill S.J.
        • Parker L.
        • Malcolm A.J.
        • Reid M.
        • More L.
        • Craft A.W.
        Incidence and survival for cancer in children and young adults in the North of England, 1968–1995.
        Br. J. Cancer. 2000; 83: 397-403
        • Berrino F.
        • Capocaccia R.
        • Gatta G.
        • et al.
        Survival of cancer patients in Europe.
        Ann. Oncol. 2003; (in press)
        • Capocaccia R.
        • Gatta G.
        • Roazzi P.
        • et al.
        The EUROCARE-3 database.
        Ann. Oncol. 2003; (in press)
        • Kramárová E.
        • Stiller C.A.
        The international classification of childhood cancer.
        Int. J. Cancer. 1996; 68: 759-765
        • World Health Organisation
        Manual of the International Statistical Classification of Diseases, Injuries and Causes of Death.
        World Health Organization, Geneva, Switzerland1977
        • Hakulinen T.
        • Abeywickrama K.H.
        A computer program package for relative survival analysis.
        Comput. Programs Biomed. 1985; 19: 197-207
        • Stiller C.A.
        • Benjamin S.
        • Cartwright R.A.
        • et al.
        Pattern of care and survival for adolescents and young adults with acute leukaemia—a population-based study.
        Br. J. Cancer. 1999; 79: 658-665
        • Chessells J.M.
        • Hall E.
        • Prentice H.G.
        • Durrant J.
        • Bailey C.C.
        • Richards S.M.
        The impact of age on outcome in lymphoblastic leukemia; MRC UKALL X and XA compared.
        Leukemia. 1998; 12: 463-473
      2. Jeha S. Who should be treating adolescents and young adults with acute lymphoblastic leukaemia? Eur J Cancer 2003, 39 this issue.

        • Secker-Walker L.M.
        • Prentice H.G.
        • Durrant J.
        • Richards S.M.
        • Hall E.
        • Harrison G.
        Cytogenetics adds independent prognostic information in adults with acute lymphoblastic leukaemia on MRC trial UKALL XA.
        Br. J. Haematol. 1997; 96: 601-610
        • Stock W.
        • Sather H.
        • Dodge R.K.
        • et al.
        Outcome of adolescents and young adults with ALL.
        Blood. 2000; 96: 476a
        • Brunetti D.
        • Tamaro P.
        • Stanta G.
        Malignancies among adolescents and young adults in the province on Trieste, Italy, 1972–1993.
        Epidemiol. Prev. 2002; 26: 130-139
        • Gatta G, Corazziari I, Magnani C, Peris-Bonet R, Roazzi P, Stiller CA and the EUROCARE Working Group
        Childhood Cancer Survival in Europe.
        Ann. Oncol. 2003; (in press)
        • Birch J.M.
        • Alston R.D.
        • Kelsey A.M.
        • Quinn M.J.
        • Babb P.
        • McNally R.J.Q.
        Classification and incidence of cancers in adolescents and young adults in England, 1979–1997.
        Br. J. Cancer. 2002; 87: 1267-1274
        • Bleyer W.A.
        • Tejeda H.
        • Murphy S.B.
        • et al.
        National Cancer Clinical Trials.
        J. Adolesc. Health. 1997; 21: 366-377
        • EUROCARE Working Group
        Ann. Oncol. 2003; (in press)
        • Xiong Q.
        • Valero V.
        • Kau V.
        • et al.
        Female patients with breast cancer aged 30 years and younger have a poor prognosis.
        Cancer. 2001; 92: 2523-2528
        • Vrieling C.
        • Collette L.
        • Fourquet A.
        • et al.
        Can patient-, treatment- and pathology-related characteristics explain the high local recurrence rate following breast-conserving therapy in younger patients?.
        Eur. J. Cancer. 2003; 39: 932-944
        • Hann I.M.
        • Stevens R.F.
        • Goldstone A.H.
        • et al.
        Randomised comparison of DAT versus ADE as induction chemotherapy in children and younger adults with acute myeloid leukemia. Results of the Medical Research Council's 10th AML trial (MRC AML10).
        Blood. 1997; 89: 2311-2318
        • Micheli A.
        • Coebergh J.W.
        • Mugno E.
        • et al.
        European health care systems in cancer care.
        Ann. Oncol. 2003; (in press)