title: Small Numbers, Big Challenges: Adolescent and Young Adult Cancer Incidence and Survival in New Zealand.
abstract: OBJECTIVE
  This study was undertaken to determine cancer survival and describe the unique spectrum of cancers diagnosed among New Zealand's adolescents and young adult (AYA) population.
  
  
  METHODS
  Registrations for 1606 15-24 year olds diagnosed with a new primary malignant tumor between 2000 and 2009 were obtained from the New Zealand Cancer Registry and classified according to AYA diagnostic group and subgroup, age, sex, and prioritized ethnicity. Age-standardized incidence rates (IRs) per million person years and 5-year relative survival ratios were calculated.
  
  
  RESULTS
  Cancer incidence was 228.6 per million for adolescents aged 15-19 years and 325.7 per million for young adults aged 20-24 years. Overall IRs were consistent across all ethnic groups but there were unique ethnic differences by tumor group including a higher incidence of bone tumors, carcinoma of the gastrointestinal tract, and gonadal germ cell tumors among Maori, a higher incidence of leukemia among Pacific peoples, and a higher incidence of melanoma among non-Maori/non-Pacific peoples. Five-year relative survival for adolescents (75.1%) and AYA overall (80.6%) appeared poorer than had been achieved in other high-income countries. Maori (69.5%) and Pacific (71.3%) AYA had lower 5-year survival compared to non-Maori/non-Pacific peoples (84.2%).
  
  
  CONCLUSIONS
  The survival disparities observed require further investigation to identify and address the causes of these inferior outcomes. The newly established AYA Cancer Network Aotearoa has been tasked with improving cancer survival and care and ensuring equality of access for New Zealand AYAs with cancer.
authors.affiliation: 1 National Child Cancer Network NZ , Auckland, New Zealand .|2 Children's Haematology Oncology Centre, Christchurch Hospital , Christchurch, New Zealand .
authors.forename: Kirsten R
authors.initials: KR
authors.lastname: Ballantine
authors.affiliation: 3 AYA Cancer Network Aotearoa , Auckland, New Zealand .
authors.forename: Heidi
authors.initials: H
authors.lastname: Watson
authors.affiliation: 1 National Child Cancer Network NZ , Auckland, New Zealand .|4 Starship Blood and Cancer Centre, Starship Children's Hospital , Auckland, New Zealand .
authors.forename: Scott
authors.initials: S
authors.lastname: Macfarlane
authors.affiliation: 4 Starship Blood and Cancer Centre, Starship Children's Hospital , Auckland, New Zealand .
authors.forename: Mark
authors.initials: M
authors.lastname: Winstanley
authors.affiliation: 2 Children's Haematology Oncology Centre, Christchurch Hospital , Christchurch, New Zealand .
authors.forename: Robin P
authors.initials: RP
authors.lastname: Corbett
authors.affiliation: 5 Department of Haematology, Christchurch Hospital , Christchurch, New Zealand .
authors.forename: Ruth
authors.initials: R
authors.lastname: Spearing
authors.affiliation: 6 Health and Disability Intelligence, New Zealand Ministry of Health, Wellington, New Zealand .
authors.forename: Vladimir
authors.initials: V
authors.lastname: Stevanovic
authors.affiliation: 7 Canterbury District Health Board , Christchurch, New Zealand .
authors.forename: Ma
authors.initials: M
authors.lastname: Yi
authors.affiliation: 8 Children's Cancer Research Group, University of Otago, Christchurch, New Zealand .|9 Children's Cancer Centre, The Royal Children's Hospital , Melbourne, Australia .
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Sullivan
mesh_terms: D000293:Adolescent; D001859:Bone Neoplasms / Q000453:epidemiology / Q000208:ethnology / Q000401:mortality; D002277:Carcinoma / Q000453:epidemiology / Q000208:ethnology / Q000401:mortality; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000453:epidemiology / Q000208:ethnology / Q000401:mortality; D054624:Health Status Disparities; D006801:Humans; D015994:Incidence; D007938:Leukemia / Q000453:epidemiology / Q000208:ethnology / Q000401:mortality; D008297:Male; D008545:Melanoma / Q000453:epidemiology / Q000208:ethnology / Q000401:mortality; D009369:Neoplasms / Q000453:epidemiology* / Q000208:ethnology / Q000401:mortality; D009373:Neoplasms, Germ Cell and Embryonal / Q000453:epidemiology / Q000208:ethnology / Q000401:mortality; D009520:New Zealand / Q000453:epidemiology; D010051:Ovarian Neoplasms / Q000453:epidemiology / Q000208:ethnology / Q000401:mortality; D012042:Registries; D012878:Skin Neoplasms / Q000453:epidemiology / Q000208:ethnology / Q000401:mortality; D015996:Survival Rate; D013736:Testicular Neoplasms / Q000453:epidemiology / Q000208:ethnology / Q000401:mortality; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: disparities; ethnicity; incidence; survival