McVeigh Una Mary, Tepper John William, McVeigh Terri Patricia
School of Medicine, National University of Ireland Galway, H91 TK33 Galway, Ireland.
Department of Internal Medicine/Pediatrics, Indiana University School of Medicine, Indianapolis, IN 46202-3082, USA.
Cancers (Basel). 2021 Nov 5;13(21):5552. doi: 10.3390/cancers13215552.
Cancer in adolescents and young adults (AYAs) deserves special consideration for several reasons. AYA cancers encompass paediatric malignancies that present at an older age than expected, or early-onset of cancers that are typically observed in adults. However, disease diagnosed in the AYA population is distinct to those same cancers which are diagnosed in a paediatric or older adult setting. Worse disease-free and overall survival outcomes are observed in the AYA setting, and the incidence of AYA cancers is increasing. Knowledge of an individual's underlying cancer predisposition can influence their clinical care and may facilitate early tumour surveillance strategies and cascade testing of at-risk relatives. This information can further influence reproductive decision making. In this review we discuss the risk factors contributing to AYA breast cancer, such as heritable predisposition, environmental, and lifestyle factors. We also describe a number of risk models which incorporate genetic factors that aid clinicians in quantifying an individual's lifetime risk of disease.
青少年和青年成人(AYA)癌症因其多种原因而值得特别关注。AYA癌症包括比预期年龄更大时出现的儿童期恶性肿瘤,或通常在成人中观察到的癌症的早发情况。然而,在AYA人群中诊断出的疾病与在儿童或老年成人环境中诊断出的相同癌症有所不同。在AYA环境中观察到较差的无病生存率和总生存率,并且AYA癌症的发病率正在上升。了解个体潜在的癌症易感性会影响其临床护理,并可能促进早期肿瘤监测策略以及对高危亲属的级联检测。这些信息可进一步影响生殖决策。在本综述中,我们讨论了导致AYA乳腺癌的风险因素,如遗传易感性、环境和生活方式因素。我们还描述了一些纳入遗传因素的风险模型,这些模型有助于临床医生量化个体一生的疾病风险。