Overall Survival Rates in AYA Cancer Lack Improvement Seen in Pediatric, Adult Cancer

Adolescent and young adult (AYA) patients with cancer who do are a race other than non-Hispanic White have a lower rate of overall survivor compared with patients of other races, according to research presented at the 2023 ASCO Annual Meeting.¹

AYA individuals with cancer—individuals between 15 and 39 years of age—are an underrecognizes population with high risk of certain cancers. Unlike pediatric and adult patients with cancer, AYA patients have not seen the same improvements in cancer survival.

Investigators conducted a retrospective cohort study of AYA patients diagnosed with cancer between 2004-2017 using the National Cancer Database; patients with the 10 deadliest AYA cancers and at least 6 months of follow-up were included. Primary study endpoints included overall survival and late stage at diagnosis (stage III/IV or Grade III/IV for central nervous system cancer).

The study cohort included a total of 291,899 patients (64% women, 65% with stage I/II cancer, 82.3% non-Hispanic White, and 62-month median follow-up). The most common cancers were breast (27%), lymphoma (16%), and melanoma (13%), followed by testicular, central nervous system, colorectal, cervical, sarcoma, ovarian, and lung.

Overall survival differed by race for all cancers except lung, central nervous system, and ovarian; it was also “significantly inferior” for Native Hawaiian and other Pacific Islander individuals in melanoma, colorectal, lymphoma, and cervical cancers (aHR, 4.5, 1.8, 1.7, and 1.6, respectively). Black individuals also experienced inferior overall survival for melanoma, lymphoma, and breast cancers (aHR, 1.6, 1.5, and 1.4, respectively), while Asian individuals had superior overall survival for breast and lung cancers, but inferior survival for testicular cancers (aHR, 0.7, 0.7, and 1.4, respectively) and American Indian and Alaska Native patients had inferior overall survival for colorectal cancer (aHR, 1.4). Late stage at diagnosis was more common for patients who were not non-Hispanic White.

“Both [Native Hawaiian and Pacific Islander] and Black AYA patients with cancer have a higher risk of death and late-stage disease at diagnosis,” the researchers concluded. “Our data reveal racial disparities among Indigenous AYA patients masked by prior data omission.”

Reference

1. Taparra KA, Kekumano K, Benevente R, et al. Racial disparities in survival and stage at diagnosis among adolescent and young adult patients with cancer. J Clin Oncol. 41, 2023(suppl 16; abstr 6615). doi:10.1200.JCO.2023.41.16_suppl.6615