Desandes Emmanuel, Stark Daniel P
Prog Tumor Res. 2016;43:1-15. doi: 10.1159/000447037. Epub 2016 Sep 5.
To design the services for adolescents and young adults (AYAs) with cancer, we need to understand the patterns of disease and the other clinical and managerial challenges of the patient group. Cancer occurring between the ages of 15 and 39 years is 4 times less rare than cancer occurring during the first 15 years of life and consists of 2% of all invasive cancer in Europe, about 66,000 patients in Europe each year. AYAs have a unique distribution of cancer types, including the peak in incidence of Hodgkin lymphoma (HL) or germ cell tumors. The relative improvement in the survival rate in AYAs has not kept pace with that achieved in younger children, especially for acute leukemia, non-HLs, Ewing tumors and rhabdomyosarcoma. Etiological factors are under-researched and remain largely hypothetical. In this unique group of illnesses, improving AYA cancer management involves bridging interfaces. Since this has begun, outcomes have also begun to improve. The local nature of these interfaces determines the age group considered as AYA. Specific skills are necessary in the clinical, biological and psychosocial domains. Services need support from policy, clinical and administrative professionals. National policy and supranational groups such as SIOPE and ESMO are in constructive collaboration to develop this further.
为了设计针对青少年和青年成人（AYA）癌症患者的服务，我们需要了解该患者群体的疾病模式以及其他临床和管理方面的挑战。15至39岁人群患癌的几率比生命最初15年患癌的几率低四倍，且占欧洲所有浸润性癌症的2%，欧洲每年约有66,000名患者。AYA癌症类型分布独特，包括霍奇金淋巴瘤（HL）或生殖细胞肿瘤发病率的峰值。AYA生存率的相对提高并未跟上年幼儿童的步伐，尤其是急性白血病、非HL、尤因肉瘤和横纹肌肉瘤。病因学因素研究不足，很大程度上仍属假设。在这一独特的疾病群体中，改善AYA癌症管理需要跨越多个领域。自开始以来，成果也已开始改善。这些领域的特点决定了被视为AYA的年龄组。临床、生物学和社会心理领域需要特定技能。服务需要政策、临床和行政专业人员的支持。国家政策以及诸如国际儿童肿瘤学会（SIOPE）和欧洲肿瘤内科学会（ESMO）等超国家组织正在进行建设性合作，以进一步推动此事。
