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Annals of Oncology Advance Access originally published online on August 25, 2008
Annals of Oncology 2009 20(2):365-373; doi:10.1093/annonc/mdn588
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© The Author 2008. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

epidemiology

Cancer in adolescents and young adults in north Netherlands (1989–2003): increased incidence, stable survival and high incidence of second primary tumours

J. C. van Gaal1,2, E. Bastiaannet3, M. Schaapveld3, R. Otter3, J. C. Kluin-Nelemans4, E. S. J. M. de Bont2,{dagger} and W. T. A. van der Graaf5,*,{dagger}

1 Department of Medical Oncology
2 Department of Paediatric Oncology, University Medical Center Groningen, University of Groningen
3 Comprehensive Cancer Center North Netherlands
4 Department of Haematology, University Medical Center Groningen, University of Groningen, Groningen
5 Department of Medical Oncology, Radboud University Nijmegen, Medical Centre Nijmegen, Nijmegen, The Netherlands

* Correspondence to: Prof. W. T. A. van der Graaf, Department of Medical Oncology, Radboud University Nijmegen, Medical Centre Nijmegen, PO Box 9101, 6500 HB Nijmegen, The Netherlands. Tel: +31-(0)24-3610353; Fax: +31-(0)24-3540788; E-mail: w.vandergraaf{at}onco.umcn.nl

Background: Lack of survival improvement in adolescents and young adults (AYA) with cancer has led to increased awareness of this young population.

Design: We carried out a population-based study of incidence and survival of primary tumours and second primary tumours in patients aged 12–24 in north Netherlands. Age-specific incidence rates per 100 000 and 3-year moving means were calculated. Factors associated with incidence and survival were assessed using a Poisson model, log-rank test and multivariate Cox proportional hazards analysis.

Results: From 1989 to 2003 a total of 1118 patients were diagnosed. The total age-specific incidence rates per 100 000 were as follows: males: 13.4 (12–15 years), 26.9 (16–19 years) and 27.5 (20–24 years) and females: 13.9, 20.7 and 20.7. Male : female ratio was 1.32. The overall estimated annual percentage change (EAPC) in incidence was 2.15% (P < 0.01). Five-year survival was 80.8% and did not improve during the study period. With median follow-up of 5.5 years (range 0.0–16.0) in our cohort the standardized incidence ratio (SIR) of second primary tumours was 30.55 (95% confidence interval = 19.96–44.76, P < 0.05).

Conclusions: The total incidence of cancer in AYA increased (EAPC = 2.15%). Survival was unchanged. The SIR of a second primary tumour in this young cohort increased 31-fold. Further research is needed to study this increasing incidence and optimise treatment outcome in these young patients.

Key words: adolescents, cancer, epidemiology, second primary, young adults

{dagger} Both authors contributed equally.

Received for publication January 29, 2008. Revision received July 20, 2008. Accepted for publication July 25, 2008.


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