An analysis of conditional survival among adolescent and young adult (AYA) survivors revealed that with the exception of a couple types of cancer, patients may have similar survival outcomes as the general population if they have survived at least 7 years after diagnosis, according to a study published in Cancer.
Many studies evaluating the long-term survivorship of childhood survivors and older adults have been done, providing much data upon which to base follow-up care. The 5-year relative survival at diagnosis for AYAs (aged 15 to 39 years) with cancer exceeds 80%, but there is a lack of research regarding survivorship among this group of patients.
For this study, researchers accessed the Surveillance, Epidemiology, and End Results database and assessed the outcomes of 205,954 AYA patients with various types of cancer, including thyroid, testicular, and breast cancers, as well as melanoma, lymphoma, leukemia, and central nervous system (CNS) tumors, diagnosed between 1973 and 2009. Investigators estimated 5-year survival at the time of diagnosis, and for every year the patient survived up to 25 years after diagnosis.
Results showed that for all cancers combined, the 5-year relative survival rate was 84.5% 1 year after diagnosis, and 94.0% at 5 years postdiagnosis.
The relative survival first exceeded 95% after 7 years, demonstrating that excess mortality — defined as death from cancer recurrences, second primary cancers or treatment-related effects — was comparable to the general population at this time.
Patients with certain cancer types reached relative survival greater than 95% quickly; patients with thyroid cancer exceed 95% at diagnosis, and patients with testicular cancer, melanoma, and breast cancer have greater than 95% relative survival at 1, 3, and 18 years, respectively.
AYA survivors with certain cancers, however, do have regressions of relative survival. The relative survival was greater than 95% for patients with Hodgkin lymphoma after 6 years and after 13 years for patients with leukemia, but after 20 years, relative survival decreased to less than 95% in both groups. Some groups, such as those with CNS tumors, did not reach a relative survival of 95% even after 25 years postdiagnosis.
The authors concluded that “for patients with cancer types such as leukemia, CNS tumors, Hodgkin lymphoma, and breast cancer, the potential for long-term excess mortality should be considered when planning follow-up care.”
1. Anderson C, Smitherman AB, Nichols HB. Conditional relative survival among long-term survivors of adolescent and young adult cancers [published online May 9, 2018]. Cancer. doi: 10.1002/cncr.31529