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TOPLINE:

Compared with the general population, adolescent and young adult (AYA) cancer survivors showed elevated risks for death from non-cancer causes, particularly in female patients with haematologic cancers and central nervous system (CNS) tumours. Cure fractions varied significantly by cancer type and age group, with substantial differences observed between adolescents and older AYA patients.

METHODOLOGY:

• This analysis included 128,647 AYAs with cancer aged 15-39 years from 63 population-based cancer registries representing 19 European countries.
• Researchers applied conventional and new mixture cure models with various parametric survival functions to estimate the cure fraction and relative risk (RR) of mortality from non-cancer causes in AYAs with cancer.

TAKEAWAY:

• RRs > 1 were found for leukaemia, chronic myeloid leukaemia, lymphoma, CNS tumours, and skin melanoma in both sexes, for testicular germ cell cancer in male patients, and for breast and cervix cancers in female patients.
• For haematologic cancers and CNS tumours, the RR of death from non-cancer causes was significantly higher in female patients than in male patients (for instance, RR, 8.6 vs 4.6 for chronic myeloid leukaemia).
• The RRs were very high for CNS tumours in 20-29-year-old women (RR, 44) and in adolescents with breast cancer (RR, 33), with the risk decreasing with increasing age.
• The cure fraction exceeded 90% for Hodgkin lymphoma, germ cell tumours, and skin melanoma in female patients, whereas it was below 50% for acute lymphoblastic leukaemia in all patients and acute myeloid leukaemia in male patients across all age groups.
• For acute lymphoblastic leukaemia in both sexes, CNS tumours in male patients, and colorectal cancers in female patients, substantial differences in cure fractions were observed between adolescents and 30-39-year-old patients, with a decrease of approximately 20 percentage points for older age groups.

IN PRACTICE:

"Estimating CF [cure fraction] for AYA cancer patients is important from an epidemiological (eg, prioritise resource allocation), clinical (eg, ensuring a tailored follow-up) and patient perspective (eg, positive psychological impact, long-term planning). Furthermore, accurate quantitation of cure in cancer patients is crucial to supporting the right of patients to be forgotten, which is especially relevant for AYA cancer patients from a financial and economic perceptive as they are often of working age, with the potential of huge impacts on their ability to access financial products such as mortgages, loans and life, health and even travel insurance," the authors wrote.

SOURCE:

This study was led by Laura Botta, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. It was published online in the European Journal of Cancer.

LIMITATIONS:

Geographical and time variability in excess mortality from other causes were not explored, necessitating caution when extrapolating the results to other populations and times. Additionally, while the stage at diagnosis was expected to influence RRs and cure fractions, the inclusion of stage information would have significantly reduced the number of cases and affected the model's capacity to estimate these parameters.

DISCLOSURES:

This study received funding through a grant from the European Commission for database preparation and cleaning. The authors reported having no relevant financial or non-financial interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.