Survival among adolescents and young adults with cancer in Germany and the United States: An international comparison
Survival among adolescents and young adults with cancer in Germany and the United States: An international comparison
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DOI：
10.1002/ijc.28231
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发表时间：
2013-11-01
影响因子：
6.4
通讯作者：
Brenner, Hermann
中科院分区：
文献类型：
--
作者：
Gondos, Adam;Hiripi, Eva;Brenner, Hermann
近年来，科学文献中出现了关于青少年和年轻成人(AYA)患者癌症生存状况和进展的严重关切。我们提供了AYA患者存活率的最新国际比较。使用来自11个德国癌症登记处和美国SEER计划的基于人群的癌症数据(分别覆盖3900万和3300万人口)、标准化的肿瘤组分类、周期分析和建模，我们比较了2002-2006年期间15-29岁和30-39岁年龄组的Aya患者的5年相对生存率与40-49岁的成年人的生存率。此外，我们还提供了两国按年龄划分的存活率比较。2002-2006年，在接受检查的30多种癌症中，绝大多数15-29岁和30-39岁的AYA患者的存活率高于或接近于两国40-49岁年龄组的患者。在Aya患者中，仅在两个人群的乳腺癌以及美国15-29岁的结直肠癌和胃癌患者中发现了大量且具有统计学意义的生存缺陷。总体而言，针对具体国家的比较结果没有显示系统性差异。除了极少数例外，在21世纪的头十年，在这两个被调查的国家中，都没有发现Aya患者和40-49岁的成年人之间的生存缺陷。有什么新的？满足青少年和年轻成人(AYA)癌症患者的需求是癌症护理的一个重要但具有挑战性的领域，由于患者存活率的缓慢提高，这一领域受到了越来越多的关注。在这里，比较德国和美国的5年存活率显示，与成人患者相比，Aya患者的存活率相似或更好。AYA存活率的进步可能归因于各种因素，包括临床试验参与率的增加和获得保险的机会的改善。这一发现可能有助于指导未来对这一特殊患者群体的护理政策。
Serious concern arose in the scientific literature about the state of and progress in cancer survival among adolescent and young adult (AYA) patients in the recent years. We provide an up-to-date international comparison of survival among AYA patients. Using population-based cancer data from 11 German cancer registries and the SEER Program of the United States (covering populations of 39 and 33 million people, respectively), standardized tumor group classifications, period analysis and modeling, we compared the 5-year relative survival of AYA patients in the age groups 15-29 and 30-39 to survival seen among adults aged 40-49 for the 2002-2006 period. Additionally, we also provide an age-specific survival comparison between the two countries. In 2002-2006, for the overwhelming majority of the more than 30 types of cancer examined, AYA patients aged both 15-29 and 30-39 years had higher or similar survival than patients in the age group 40-49 in both countries. A numerically large and statistically significant survival deficit among AYA patients was only found for breast carcinomas in both populations, and colorectal and stomach carcinoma in the United States for the age group 15-29. Overall, results of the country-specific comparisons did not indicate systematic differences. With very few exceptions, no survival deficit between AYA patients and adults aged 40-49 years was found in either of the examined countries in the first decade of the 21st century.What's new? Meeting the needs of adolescent and young adult (AYA) cancer patients is a vital yet challenging area of cancer care, one that has received increased attention due to slow gains in patient survival. Here, comparison of 5-year survival in Germany and the United States reveals similar or better survival for AYA patients compared with adult patients. Progress in AYA survival may be attributed to various factors, including increased clinical trial participation and improved access to insurance. The findings could help direct future care policy for this special patient population.