title: Cancer in adolescents and young adults in north Netherlands (1989-2003): increased incidence, stable survival and high incidence of second primary tumours.
abstract: BACKGROUND
  Lack of survival improvement in adolescents and young adults (AYA) with cancer has led to increased awareness of this young population.
  
  
  METHODS
  We carried out a population-based study of incidence and survival of primary tumours and second primary tumours in patients aged 12-24 in north Netherlands. Age-specific incidence rates per 100,000 and 3-year moving means were calculated. Factors associated with incidence and survival were assessed using a Poisson model, log-rank test and multivariate Cox proportional hazards analysis.
  
  
  RESULTS
  From 1989 to 2003 a total of 1118 patients were diagnosed. The total age-specific incidence rates per 100,000 were as follows: males: 13.4 (12-15 years), 26.9 (16-19 years) and 27.5 (20-24 years) and females: 13.9, 20.7 and 20.7. Male : female ratio was 1.32. The overall estimated annual percentage change (EAPC) in incidence was 2.15% (P < 0.01). Five-year survival was 80.8% and did not improve during the study period. With median follow-up of 5.5 years (range 0.0-16.0) in our cohort the standardized incidence ratio (SIR) of second primary tumours was 30.55 (95% confidence interval = 19.96-44.76, P < 0.05).
  
  
  CONCLUSIONS
  The total incidence of cancer in AYA increased (EAPC = 2.15%). Survival was unchanged. The SIR of a second primary tumour in this young cohort increased 31-fold. Further research is needed to study this increasing incidence and optimise treatment outcome in these young patients.
authors: Department of Medical Oncology, University Medical Center Groningen, University of Groningen, The Netherlands.
authors: J C
authors: JC
authors: van Gaal
authors: E
authors: E
authors: Bastiaannet
authors: M
authors: M
authors: Schaapveld
authors: R
authors: R
authors: Otter
authors: J C
authors: JC
authors: Kluin-Nelemans
authors: E S J M
authors: ES
authors: de Bont
authors: W T A
authors: WT
authors: van der Graaf
mesh_terms: D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D005843:Geography; D006801:Humans; D015994:Incidence; D008297:Male; D009369:Neoplasms / Q000453:epidemiology* / Q000401:mortality; D016609:Neoplasms, Second Primary / Q000453:epidemiology* / Q000209:etiology; D009426:Netherlands / Q000453:epidemiology; D011159:Population Surveillance; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D055815:Young Adult