title: Survival from teenage and young adult cancer in Northern England, 1968-2008.
abstract: BACKGROUND
  Although cancer is relatively rare in teenagers and young adults (TYAs) aged 15-24 years, it is a major cause of death in this age group. This study investigated survival trends in TYA cancer diagnosed in Northern England, 1968-2008.
  
  
  METHODS
  Five-year survival was analyzed using Kaplan-Meier estimation for four successive time periods. Cox regression analysis was used to investigate associations with demographic factors.
  
  
  RESULTS
  The study included 2,987 cases (1,634 males, 1,353 females). Five-year survival for all patients with cancer improved greatly from 46% in 1968-1977 to 84% in 1998-2008 (P < 0.001), for patients with leukemia from 2% to 71% (P < 0.001), lymphoma from 66% to 86% (P < 0.001), central nervous system tumors from 53% to 84% (P < 0.001), bone tumors from 29% to 72% (P < 0.001), germ cell tumors from 39% to 94% (P < 0.001), melanoma and skin cancer from 64% to 100% (P < 0.001), and carcinomas from 48% to 80% (P < 0.001). Cox analysis showed that for all patients with cancer, survival was better for females than males (HR = 0.83; 95% CI 0.74-0.94, P < 0.001), for patients aged 20-24 years compared with those aged 15-19 years (HR = 0.84; 95% CI 0.75-0.94, P = 0.002), but survival was worse for patients who resided in more deprived areas (HR = 1.06; 95% CI 1.01-1.11, P = 0.025).
  
  
  CONCLUSIONS
  There have been large improvements in TYA cancer survival in Northern England over the last four decades. Future work should determine factors that could lead to even better survival, including possible links with delayed diagnosis.
authors.affiliation: Institute of Health and Society, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom.
authors.forename: N O
authors.initials: NO
authors.lastname: Basta
authors.forename: P W
authors.initials: PW
authors.lastname: James
authors.forename: B
authors.initials: B
authors.lastname: Gomez-Pozo
authors.forename: A W
authors.initials: AW
authors.lastname: Craft
authors.forename: P
authors.initials: P
authors.lastname: Norman
authors.forename: R J Q
authors.initials: RJ
authors.lastname: McNally
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004739:England / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009026:Mortality / Q000639:trends*; D009369:Neoplasms / Q000145:classification / Q000401:mortality*; D011379:Prognosis; D015996:Survival Rate; D013997:Time Factors; D055815:Young Adult
keywords: cancer; leukemia; lymphoma; solid tumors; survival; teenagers and young adults