Adolescent and young adult (AYA) oncology is described as “the interface of paediatric and adult oncology”.1 A diverse range of cancers affect this age group, including cancers such as acute…
The full contents of this page is only available to subscribers.
To view this content please login or subscribe
Due to our small population and geographic spread, New Zealand faces unique challenges in providing high-quality, comprehensive adolescent and young adult (AYA) cancer services. A 2000–2009 15–24-year analysis showed poorer survival for Māori and Pacific Peoples and for AYA diagnosed with certain cancers such as bone tumours. This has led to a major national focus to improve the outcomes for our AYA population, including the establishment of the AYA Cancer Network Aotearoa in 2013 and the release of the AYA Standards of Care in May 2017. In this paper we report a comprehensive analysis of the incidence and outcome for 25–29 year-old cancer patients. In addition, this paper introduces the AYA Cancer Network and provides the New Zealand medical community with an overview of some the current issues in AYA oncology, including the lack of a clear AYA age range and barriers to increasing clinical trial participation rates for this at-risk population.
New Zealand currently defines the adolescent and young adult (AYA) group for cancer services as young people 12–24 years of age, while other countries favour a designation of 15–29 years. This study was undertaken to compare cancer incidence and survival among 25–29 year olds to New Zealand’s younger AYA population and to assess survival for our 15–29 year population against international benchmarks.
Diagnostic and demographic information for cancer registrations between 2000 and 2009 for 25–29 year olds was obtained from the New Zealand Cancer Registry. Incidence rates (IR) and five-year relative survival estimates were calculated according to AYA diagnostic group/sub-group, sex and prioritised ethnicity.
1,541 new primary malignant cancers were diagnosed (IR: 588 per million). Five-year relative survival was 85%, but was significantly lower for Māori and Pacific peoples (both 77%) compared to non-Māori/non-Pacific peoples (88%). In the overall 15–29 year AYA cohort, disease-specific outcomes for bone tumours (46%) and breast cancer (64%) were inferior to international standards.
New Zealand 25 to 29 year olds are at twice the risk of developing cancer as those 15–24 years. Given that the survival disparities identified were remarkably consistent with those for younger AYA, consideration should be given widening New Zealand’s AYA age range.