Department of Medical Oncology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Oncology. 2022;100(3):140-147. doi: 10.1159/000520291. Epub 2022 Jan 31.
Cancer is one of the main causes of death among adolescents and young adults (AYAs) aged 15-39 years. The improvement in overall 5-year survival in AYA cancer patients was far below than that of adult cancer patients. The purpose of this study was to clarify the features of cancer in AYAs by comparing them with those of controls.
Patients in the cancer registry of the University of Tsukuba Hospital between 2007 and 2017 (median age, 65 years) were included in this study. We used patients between the ages of 64 and 66 years as controls. We then obtained the age at diagnosis, sex, primary site, and pathological type.
Among 27,281 cancer patients in the registry between 2007 and 2017, 1,947 (7.1%) patients were categorized into the AYA group, and 2,354 into the control group. Among men in the AYA group, central nervous system (CNS) tumors accounted for 22.7% of all cancers, followed by germ cell tumors, 22.5%, and hematopoietic malignancies, 12.5%. Among women in the AYA group, cervical cancer accounted for 35.9% of all cancers, followed by breast cancer, 14.6%, and CNS tumors, 11.6%. The proportion of specific cancer types relative to all cancers in the CNS, thyroid, adrenal glands, germ cells, cervix uteri, hematopoietic tissues, and sarcomas was higher in the AYA group than that in the control group.
The present results for AYAs were in sharp contrast to those for adult cancers and may be related to different modes of pathogenesis in AYAs. The identification of high-risk groups of these tumors in the AYA generation is crucial for prevention and early detection and will be a major topic for future research. While most of adult cancers are treated independently by each medical department, AYA cancers need to be treated in collaboration with experts from several departments. It is desirable to address the issues involved in applying treatments established for adult cancers to AYA cancers on a cancer-by-cancer basis.
癌症是 15-39 岁青少年和青年（AYA）人群死亡的主要原因之一。AYA 癌症患者的整体 5 年生存率的提高远低于成年癌症患者。本研究旨在通过与对照组进行比较，阐明 AYA 癌症患者的特征。
本研究纳入了 2007 年至 2017 年期间在筑波大学医院癌症登记处的患者（中位年龄 65 岁）。我们将年龄在 64-66 岁的患者作为对照组。然后，我们获得了诊断时的年龄、性别、原发部位和病理类型。
在 2007 年至 2017 年期间的癌症登记处中，有 27281 名癌症患者，其中 1947 名（7.1%）患者被归入 AYA 组，2354 名归入对照组。在 AYA 组男性中，中枢神经系统（CNS）肿瘤占所有癌症的 22.7%，其次是生殖细胞肿瘤，占 22.5%，造血恶性肿瘤，占 12.5%。在 AYA 组女性中，宫颈癌占所有癌症的 35.9%，其次是乳腺癌，占 14.6%，CNS 肿瘤，占 11.6%。与对照组相比，CNS、甲状腺、肾上腺、生殖细胞、子宫颈、造血组织和肉瘤中特定癌症类型在所有癌症中的比例在 AYA 组中更高。
AYA 的结果与成人癌症的结果形成鲜明对比，这可能与 AYA 发病机制的不同模式有关。确定 AYA 人群中这些肿瘤的高危人群对于预防和早期发现至关重要，这将是未来研究的主要课题。虽然大多数成人癌症由每个医学部门独立治疗，但 AYA 癌症需要与来自多个部门的专家合作治疗。在逐个癌症的基础上，解决将为成人癌症制定的治疗方法应用于 AYA 癌症所涉及的问题是很有必要的。
