Patterns of Care - Dx 2006 Feasibility Adolescent and Young Adult

与较年轻和较年长的癌症人群相比，SEER数据表明，年龄在15岁至39岁之间的青少年和青壮年（AYA）人群几十年来的癌症存活率几乎没有改善。2005年，美国国家癌症研究所与兰斯·阿姆斯特朗基金会合作，成立了一个进展审查小组（PRG），以解决美国癌症协会癌症人群的特殊研究和癌症护理需求。PRG确定了与癌症护理提供相关的重要潜在因素，这些因素可能导致许多AYA癌症患者的相对预后较差，包括：患者获得护理的机会、诊断延误、癌症治疗环境和护理提供者使用的特定治疗方法。根据SEER提供的数据，最近的进展审查小组（PRG）关于青少年和年轻人癌症（AYA）的报告确定AYA的随访是一个高度优先事项。虽然大多数年龄组的生存率都在增加，但对AYA来说却没有。因此，PRG建议应特别强调收集这些被诊断为癌症的个体的当前和完整的治疗数据。这些患者经常陷入儿科和成人肿瘤之间的“无人区”。对AYAs的研究进一步受到了限制，因为他们很少参与相对较少的临床试验，部分原因是诊断医生很少推荐这些患者参加试验。护理的不一致性，加上研究数据的不足，阻碍了治疗和监测患有癌症的aya的指南的制定，而且很少有工具可以衡量在不同环境中提供的治疗和社会心理干预的效果。PRG确定，对这一人群的研究具有高度的科学优先性。为了解决这些差距，我们组建了一个跨nci和校外团队，计划从2007年10月开始对大约500名AYA患者进行可行性研究。

Compared to younger and older aged cancer populations, SEER data suggest that the adolescent and young adult (AYA) population between the ages of 15 and 39 years has seen little or no improvement in cancer survival rates for decades. In 2005, the National Cancer Institute partnered with the Lance Armstrong Foundation and developed a Progress Review Group (PRG) to address the special research and cancer care needs of the AYA cancer population. The PRG identified important potential factors related to cancer care delivery that may contribute to the poorer relative outcome for many AYA cancer patients including: the patient access to care, delays in diagnosis, the cancer treatment setting and specific treatment practices used by care providers. Using the data provided by SEER the recent Progress Review Group (PRG) Report on Cancer in Adolescent and Young Adults (AYA) determined that follow-up of AYA was a high priority. While survival has been increasing for most age groups, it has not for AYA. Therefore, the PRG suggested a special emphasis should be placed on collection of current and complete treatment data for these individuals diagnosed with cancer. These patients too frequently fall into a ¿no man's land¿ between pediatric and adult oncology. Research on AYAs has been further constrained by their exceedingly low participation in the relatively few clinical trials available to them, in part because diagnosing physicians seldom refer these patients to trials. Inconsistency in care, coupled with insufficient research data, has prevented the development of guidelines for treating and monitoring AYAs with cancer, and few tools exist to measure the efficacy of treatment and psychosocial interventions delivered in diverse settings. The PRG determined that research in this population was a high scientific priority. To address these gaps, we have assembled a trans-NCI and extramural team to plan a feasibility study to include approximately 500 AYA patients beginning in October 2007.