Survival of Adolescents and Young Adults with Prevalent Poor-Prognosis Metastatic Cancers: A Population-based Study of Contemporary Patterns and Their Implications

Details

• Alternative Title:
  Cancer Epidemiol Biomarkers Prev
• Personal Author:
  Bhutada, Jessica K. Sheth ; Hwang, Amie E. ; Liu, Lihua ; Tsai, Kai-ya ; Deapen, Dennis ; Freyer, David R.
• Description:
  Background:
  
  Although survival has improved dramatically for most adolescents and young adults (AYAs, 15–39 years old) with cancer, it remains poor for those presenting with metastatic disease. To better characterize this subset, we conducted a landscape survival comparison with older adults (OAs, 40–79 years).
  
  Methods:
  
  Using Surveillance, Epidemiology, and End Results Program data from 2000–2016, we examined incident cases of poor-prognosis metastatic cancers (5-year survival < 50%) among AYAs (n=11,518) and OAs (n=345,681) and compared cause-specific survival by sociodemographic characteristics (race/ethnicity, sex, and socioeconomic status). Adjusted hazard ratios (aHRs) for death from metastatic disease (95% confidence intervals [95%CI]) were compared between AYAs and OAs (pint).
  
  Results:
  
  AYAs had significantly better survival than OAs for every cancer site except kidney, where it was equivalent (range of aHRs: 0.91 [95%CI 0.82–1.02] for kidney cancer to 0.33 [0.26–0.42] for rhabdomyosarcoma). Compared to their OA counterparts, greater survival disparities existed for AYAs who were non-Hispanic Black with uterine cancer (aHR=2.20 [1.25–3.86] versus 1.40 [1.28–1.54]; pint=0.049) and kidney cancer (aHR=1.51 [1.15–1.98] versus 1.10 [1.03–1.17]; pint=0.04); non-Hispanic Asian/Pacific Islanders with ovarian cancer (aHR=1.47 [1.12–1.93] versus 0.89 [0.84–0.95], pint<0.001); and males with colorectal cancer (aHR=1.21 [1.10–1.32] versus 1.08 [1.06–1.10]; pint=0.045)).
  
  Conclusions:
  
  AYAs diagnosed with these metastatic cancers have better survival than OAs, but outcomes remain dismal.
  
  Impact:
  
  Overcoming the impact of metastasis in these cancers is necessary for continuing progress in AYA oncology. Sociodemographic disparities affecting AYAs within kidney, uterine, ovarian, and colorectal cancer could indicate plausible effects of biology, environment, and/or access and should be explored.
  
  
• Subjects:
  Adolescent Adult Aged Ethnicity Humans Kidney Neoplasms Male Prognosis Research Social Class Young Adult

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• Keywords:
  Adolescents Alzheimer's Disease Alzheimer's Disease Sequencing Project Antiviral Agents AYAs Herpes Simplex Human Papillomavirus Metastatic Cancer Survival Torque Teno Viruses Whole Exome Sequencing Whole Genome Sequencing Young Adults

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• Source:
  Cancer Epidemiol Biomarkers Prev. 31(4):900-908
• Pubmed ID:
  35086824
• Pubmed Central ID:
  PMC8983591
• Document Type:
  Journal Article
• Funding:
  HHSN261201000140C/CA/NCI NIH HHSUnited States/ ; HHSN261201000035C/CA/NCI NIH HHSUnited States/ ; HHSN261201000035I/CA/NCI NIH HHSUnited States/ ; HHSN261201000034C/CA/NCI NIH HHSUnited States/ ; UL1 TR001855/TR/NCATS NIH HHSUnited States/ ; U58 DP003862/DP/NCCDPHP CDC HHSUnited States/
• Volume:
  31
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:e1166a01d52b77b5e988e70f895e25880b1970b8e8615f8c9d84165659b81e98b2e318a037ef138329ef16f454639fb941592446f2ecb0f819647a5e482cae1e
• Download URL:
  https://stacks.cdc.gov/view/cdc/116086/cdc_116086_DS1.pdf
• File Type:
  [PDF - 499.42 KB ]