Birch J M, Pang D, Alston R D, Rowan S, Geraci M, Moran A, Eden T O B
Cancer Research UK, Paediatric and Familial Cancer Research Group, University of Manchester, Royal Manchester Children's Hospital, Stancliffe, Hospital Road, Manchester M27 4HA, UK.
Br J Cancer. 2008 Sep 2;99(5):830-5. doi: 10.1038/sj.bjc.6604460. Epub 2008 Aug 19.
Cancer is the leading cause of disease-related death in teenagers and young adults aged 13-24 years (TYAs) in England. We have analysed national 5-year relative survival among more than 30,000 incident cancer cases in TYAs. For cancer overall, 5-year survival improved from 63% in 1979-84 to 74% during 1996-2001 (P<0.001). However, there were no sustained improvements in survival over time among high-grade brain tumours and bone and soft tissue sarcomas. Survival patterns varied by age group (13-16, 17-20, 21-24 years), sex and diagnosis. Survival from leukaemia and brain tumours was better in the youngest age group but in the oldest from germ-cell tumours (GCTs). For lymphomas, bone and soft tissue sarcomas, melanoma and carcinomas, survival was not significantly associated with age. Females had a better survival than males except for GCTs. Most groups showed no association between survival and socioeconomic deprivation, but for leukaemias, head and neck carcinoma and colorectal carcinoma, survival was significantly poorer with increasing deprivation. These results will aid the development of national specialised service provision for this age group and identify areas of clinical need that present the greatest challenges.
癌症是英格兰13至24岁青少年及青年(TYAs)中与疾病相关的主要死因。我们分析了30000多例TYAs新发癌症病例的全国5年相对生存率。总体而言,癌症的5年生存率从1979 - 1984年的63%提高到了1996 - 2001年的74%(P<0.001)。然而,高级别脑肿瘤以及骨肉瘤和软组织肉瘤的生存率并未随时间持续改善。生存模式因年龄组(13 - 16岁、17 - 20岁、21 - 24岁)、性别和诊断而异。白血病和脑肿瘤在最年轻年龄组的生存率更高,而生殖细胞肿瘤(GCTs)在最年长年龄组的生存率更高。对于淋巴瘤、骨肉瘤和软组织肉瘤、黑色素瘤及 carcinomas,生存率与年龄无显著关联。除了GCTs外,女性的生存率高于男性。大多数组的生存率与社会经济贫困状况无关,但对于白血病、头颈癌和结直肠癌,贫困程度越高,生存率越低。这些结果将有助于为该年龄组制定全国性的专科服务,并确定面临最大挑战的临床需求领域。