title: Pathways of care for adolescent patients with cancer in France from 2006 to 2007.
abstract: BACKGROUND
  In France, as in other countries, there is a need for a population-based view of access to care and modalities of treatment for adolescents with cancer.
  
  
  METHODS
  Using a population-based registration, we report pathways of care for 15-19-year-old patients, diagnosed with cancer in 2006 and 2007, living in six French regions, accounting for 41% of the French population.
  
  
  RESULTS
  The median times (inter-quartile range) for diagnosis and treatment of the 594 included adolescents were 8 weeks (3-17) and 3 days (0-16), respectively. First physicians met by the patients were mostly general practitioners (59%). Seventeen percent of patients were firstly seen on emergency wards. Most of the patients (82%) were treated in an adult environment. Management decisions were taken within the context of a multi-disciplinary team (MDT) in 54% of cases. Twenty-seven percent of patients were included in randomized or non-randomized clinical studies: percentage depended on the tumor type and on the number of on-going trials at the study period. Fifteen percent of patients were included in pediatric studies, 7% in adult studies, and 5% in studies including both adults and children.
  
  
  CONCLUSIONS
  The pathways of care for French adolescent patients with cancer are heterogeneous. Our results reveal differences in MDT meetings according to tumor types and a lack of effective collaboration between pediatric and adult wards. Efforts must be made to develop cancer networks to ensure that adolescents receive the optimal care in a suitable environment.
authors.affiliation: National Registry of Childhood Solid Tumors, Nancy, France. emmanuel.desandes@medecine.uhp-nancy.fr
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Desandes
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Bonnay
authors.forename: Claire
authors.initials: C
authors.lastname: Berger
authors.forename: Laurence
authors.initials: L
authors.lastname: Brugieres
authors.forename: François
authors.initials: F
authors.lastname: Demeocq
authors.forename: Valérie
authors.initials: V
authors.lastname: Laurence
authors.forename: Danièle
authors.initials: D
authors.lastname: Sommelet
authors.forename: Isabelle
authors.initials: I
authors.lastname: Tron
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Clavel
authors.forename: Brigitte
authors.initials: B
authors.lastname: Lacour
mesh_terms: D000293:Adolescent; D002986:Clinical Trials as Topic; D005260:Female; D005602:France; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006405:Hematology / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000706:statistics & numerical data; D009369:Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D010372:Pediatrics / Q000706:statistics & numerical data; D010820:Physicians / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data; D055815:Young Adult