Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.
Department of Haematology, University Hospital of Copenhagen Rigshospitalet, Copenhagen, Denmark.
Br J Cancer. 2019 Dec;121(12):1079-1084. doi: 10.1038/s41416-019-0632-1. Epub 2019 Nov 13.
The present study aimed to assess whether the widespread concern of inferior cancer survival in adolescents and young adults (AYAs) compared with children and adults holds true in a Nordic setting with important differences in healthcare organisation compared with the United States (e.g. free access to healthcare) and the United Kingdom (e.g. young teenagers are treated in paediatric departments).
Five-year relative survival was calculated for 17 diagnostic groups in patients diagnosed in 2000-2013 in three diagnostic age categories: children (0-14 years), AYAs (15-24 years) and adults (25-34 years).
For 13 out of 17 diagnostic groups examined, there was no difference in survival between AYAs and neighbouring age categories. For acute lymphoblastic leukaemias, astrocytomas, rhabdomyosarcomas and non-rhabdomyosarcoma soft tissue sarcomas we found survival in children to be superior to that in AYAs. For these four diagnostic groups, the rate of survival improvement over three calendar periods (1980-1989, 1990-1999 and 2000-2013) was not particularly low in AYAs compared with neighbouring age categories.
The present study suggests that in an affluent setting with free access to healthcare, meaningful differences in survival between AYA patients and either childhood or adult patients are a phenomenon of the past for most AYA cancer diagnostic groups.
本研究旨在评估在北欧国家,与美国(例如,医疗保健免费)和英国(例如,青少年在儿科部门接受治疗)相比,青少年和年轻人(AYAs)的癌症生存率普遍较低的担忧是否成立,北欧国家在医疗保健组织方面存在重要差异。
计算了 2000-2013 年间三个诊断年龄组(儿童(0-14 岁)、AYAs(15-24 岁)和成人(25-34 岁))中 17 个诊断组的 5 年相对生存率。
在所检查的 17 个诊断组中,有 13 个诊断组在生存率方面,AYAs 与相邻年龄组之间没有差异。对于急性淋巴细胞白血病、星形细胞瘤、横纹肌肉瘤和非横纹肌肉瘤软组织肉瘤,我们发现儿童的生存率优于 AYAs。对于这四个诊断组,在三个日历期间(1980-1989 年、1990-1999 年和 2000-2013 年),生存率的改善率在 AYAs 与相邻年龄组之间并不特别低。
本研究表明,在一个拥有免费医疗保健的富裕环境中,对于大多数 AYA 癌症诊断组,AYA 患者与儿童或成年患者之间的生存率存在显著差异的现象已经成为过去。