• Changes in cancer incidence in teenagers and young adults (ages 13 to 24 years) in England 1979-2003.

      Alston, Robert D; Geraci, Marco; Eden, Tim O B; Moran, Anthony; Rowan, Steve; Birch, Jillian M; Cancer Research UK Pediatric and Familial Cancer Research Group, Royal Manchester Children's Hospital, University of Manchester, Stancliffe, Manchester, United Kingdom. robert.d.alston@manchester.ac.uk (2008-11-15)
      BACKGROUND: Cancer for teenagers and young adults represents a major source of morbidity and mortality. Trends in cancer incidence can provide pointers concerning how changes in the environment and in personal behavior affect cancer risks. METHODS: Data on 39,129 neoplasms in individuals ages 13 to 24 years who were diagnosed in England from 1979 to 2003 were analyzed. Variability in incidence by time period and differences in the time trends by age group, sex, and geographic region were analyzed using generalized linear models. RESULTS: Incidence rates of leukemias, lymphomas, central nervous system, bone, and germ cell tumors; melanoma; and carcinomas of the thyroid, ovary, cervix, and colon/rectum increased over time (all P < .01); whereas the incidence of carcinomas of the stomach and bladder decreased (both P < .01). These changes were consistent by age, sex, and region for most neoplasms. Melanoma incidence stabilized in southern England by 1993 but continued to increase in northern England (P = .001). The increase in non-Hodgkin lymphoma was greater in individuals ages 20 to 24 year than in younger individuals, but the increase in Hodgkin lymphoma was confined to individuals ages 13 to 14 years. CONCLUSIONS: The changes in incidence rates may have been caused in part by environmental changes and in part by behavioral changes in young individuals. Some of these results can be used to inform public health campaigns, which can be constructed to encourage better lifestyle choices by young individuals.
    • Survival from cancer in teenagers and young adults in England, 1979-2003.

      Birch, Jillian M; Pang, Dong; Alston, Robert D; Rowan, Steve; Geraci, Marco; Moran, Anthony; Eden, Tim O B; Cancer Research UK, Paediatric and Familial Cancer Research Group, University of Manchester, Royal Manchester Children's Hospital, Stancliffe, Hospital Road, Manchester M27 4HA, UK. jillian.birch@manchester.ac.uk (2008-09-02)
      Cancer is the leading cause of disease-related death in teenagers and young adults aged 13-24 years (TYAs) in England. We have analysed national 5-year relative survival among more than 30,000 incident cancer cases in TYAs. For cancer overall, 5-year survival improved from 63% in 1979-84 to 74% during 1996-2001 (P<0.001). However, there were no sustained improvements in survival over time among high-grade brain tumours and bone and soft tissue sarcomas. Survival patterns varied by age group (13-16, 17-20, 21-24 years), sex and diagnosis. Survival from leukaemia and brain tumours was better in the youngest age group but in the oldest from germ-cell tumours (GCTs). For lymphomas, bone and soft tissue sarcomas, melanoma and carcinomas, survival was not significantly associated with age. Females had a better survival than males except for GCTs. Most groups showed no association between survival and socioeconomic deprivation, but for leukaemias, head and neck carcinoma and colorectal carcinoma, survival was significantly poorer with increasing deprivation. These results will aid the development of national specialised service provision for this age group and identify areas of clinical need that present the greatest challenges.