title: Treatment setting, clinical trial enrollment, and subsequent outcomes among adolescents with cancer: a literature review.
abstract: BACKGROUND
  There has been an overall improvement in survival rates for persons with cancer over the past 35 years. However, these gains are less prevalent among adolescents with cancer aged 15 to 19 years, which may be due to lower clinical trial enrollment among adolescents with cancer.
  
  
  METHODS
  We conducted a literature review to assess current research regarding clinical trial enrollment and subsequent outcomes among adolescents with cancer. The search included English-language publications that reported original data from January 1985 to October 2011.
  
  
  RESULTS
  The search identified 539 records. Of these 539 records, there were 30 relevant original research articles. Multiple studies reported that adolescents with cancer are enrolled in clinical trials at lower rates compared with younger children and older adults. Treatment setting, physician type, and institution type may all be factors in the low enrollment rate among adolescents. Few data focused solely on adolescents, with many studies combining adolescents with young adults. The number of available studies related to this topic was limited, with significant variability in study design, methods, and outcomes.
  
  
  CONCLUSIONS
  This literature review suggests that adolescents with cancer are not treated at optimal settings and are enrolled in clinical trials at low rates. This may lead to inferior treatment and poor subsequent medical and psychosocial outcomes. The scarcity in data further validates the need for additional research focusing on this population.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia; etai@cdc.gov.
authors.forename: Eric
authors.initials: E
authors.lastname: Tai
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia;
authors.forename: Natasha
authors.initials: N
authors.lastname: Buchanan
authors.affiliation: SciMetrika LLC, Research Triangle Park, North Carolina; and.
authors.forename: Lauren
authors.initials: L
authors.lastname: Westervelt
authors.affiliation: SciMetrika LLC, Research Triangle Park, North Carolina; and.
authors.forename: Dena
authors.initials: D
authors.lastname: Elimam
authors.affiliation: Department of Biostatistics, School of Public Health, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: Silvana
authors.initials: S
authors.lastname: Lawvere
mesh_terms: D000293:Adolescent; D002986:Clinical Trials as Topic / Q000379:methods*; D006801:Humans; D009369:Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D018579:Patient Selection; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome; D055815:Young Adult
keywords: adolescents; cancer; clinical trial enrollment; oncology