Comparison of cancer survival trends in the United States of adolescents and young adults with those in children and older adults


  • Theresa H.M. Keegan MS, PhD,

    Corresponding author
    1. Department of Internal Medicine, Division of Hematology and Oncology, University of California Davis School of Medicine, Sacramento, California
    • Corresponding author: Theresa H.M. Keegan, MS, PhD, Division of Hematology and Oncology, UC Davis Comprehensive Cancer Center, 4501 X Street, Suite 3016, Sacramento, CA 95817; Fax: (916) 734-7946;

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  • Lynn A.G. Ries MS,

    1. Surveillance Research Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
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  • Ronald D. Barr MB ChB, MD,

    1. Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
    2. Department of Pathology, McMaster University, Hamilton, Ontario, Canada
    3. Department of Medicine, McMaster University, Hamilton, Ontario, Canada
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  • Ann M. Geiger PhD,

    1. Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
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  • Deborah Vollmer Dahlke DrPH,

    1. Texas A&M Health Science Center School of Public Health, College Station, Texas
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  • Bradley H. Pollock MPH, PhD,

    1. Department of Public Health Sciences, University of California at Davis, Davis, California
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  • W. Archie Bleyer MD,

    1. St. Charles Regional Cancer Center, Bend, Oregon
    2. Department of Radiation Medicine, Oregon Health and Science University, Portland, Oregon
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  • for the National Cancer Institute Next Steps for Adolescent and Young Adult Oncology Epidemiology Working Group



With prior reports indicating a lack of progress in survival improvement in older adolescents and young adults (AYAs) aged 15 to 39 years with cancer compared with both younger and older patients with cancer, the current analysis provides an update of survival trends of cancers among AYAs, children, and older adults.


Data from the National Cancer Institute Surveillance, Epidemiology, and End Results database for 13 regions were used to ascertain survival trends of the 34 most frequent cancers diagnosed in AYAs compared with children and older adults.


As of 2002 through 2006, the 5-year relative survival rate for all invasive cancers in AYAs was 82.5% (standard error, 0.2%). In AYAs, 14 cancers demonstrated evidence of a statistically significant improvement in their 5-year relative survival since 1992. Survival improved less in AYAs than in children for acute myeloid leukemia and medulloblastoma. Fourteen cancers had survival improvements that were found to be less in AYAs compared with older adults, including hepatic carcinoma, acute myeloid leukemia, high-grade astrocytoma, acute lymphocytic leukemia, pancreatic carcinoma, low-grade astrocytoma, gastric carcinoma, renal carcinoma, cancer of the oral cavity and pharynx, Hodgkin lymphoma, ovarian cancer, fibromatous sarcoma, other soft tissue sarcoma, and thyroid carcinoma.


Improvements in the survival of several cancer types that occur frequently in AYAs are encouraging. However, survival does not appear to be improving to the same extent in AYAs as in children or older adults for several cancers. Further investment in exploring the distinct biology of tumors in this age group, and of their hosts, must be a priority in AYA oncology. Cancer 2016;122:1009–1016. © 2016 American Cancer Society