Classification and incidence of cancers in adolescents and young adults in England 1979-1997.
Cancer patients aged 15-24 years have distinct special needs. High quality cancer statistics are required for service planning. Data presented by primary site are inappropriate for this age group. We have developed a morphology-based classification and applied it to national cancer registration data for England 1979-1997. The study included 25,000 cancers and 134 million person-years at risk. Rates for each diagnostic group by age, sex and time period (1979-83, 1984-87, 1988-92, 1993-1997) were calculated. Overall rates in 15-19 and 20-24-year-olds were 144 and 226 per million person-years respectively. Lymphomas showed the highest rates in both age groups. Rates for leukaemias and bone tumours were lower in 20-24 year olds. Higher rates for carcinomas, central nervous system tumours, germ-cell tumours, soft tissue sarcomas and melanoma were seen in the older group. Poisson regression showed incidence increased over the study period by an average of 1.5% per annum (P<0.0001). Significant increases were seen in non-Hodgkins lymphoma (2.3%), astrocytoma (2.3%), germ-cell tumours (2.3%), melanoma (5.1%) and carcinoma of the thyroid (3.5%) and ovary (3.0%). Cancers common in the elderly are uncommon in adolescents and young adults. The incidence of certain cancers in the latter is increasing. Future studies should be directed towards aetiology.
Birch
J M
JM
Cancer Research UK, Paediatric & Familial Cancer Research Group, Royal Manchester Children's Hospital, Stancliffe, Hospital Road, Manchester M27 4HA, UK. jillian.birch@man.ac.uk
Alston
R D
RD
Kelsey
A M
AM
Quinn
M J
MJ
Babb
P
P
McNally
R J Q
RJ
D000293:Adolescent; D000328:Adult; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009369:Neoplasms / Q000145:classification* / Q000453:epidemiology*; D012042:Registries / Q000706:statistics & numerical data*; D012044:Regression Analysis; D012189:Retrospective Studies; D018570:Risk Assessment