About the research
Although cancer is relatively rare in teenagers and young adults 15 to 24 years old, it is a major cause of death in this age group. The aim of this study is to investigate survival trends in teenagers and young adults diagnosed with cancer and living in northern England between 1968 and 2008. The research was conducted in Northern England because it is the most deprived of all the English regions; hence improvements in this region could reduce health inequalities.
The study included 2,987 cases, 1,634 of them males and 1,353 females. Results showed that five-year survival for all patients with cancer improved greatly from 46 per cent (in the period 1968 to 1977) to 84 per cent (between 1998 and 2008).
In particular, for patients with leukaemia survival improved from 2 per cent to 71 per cent, lymphoma from 66 per cent to 86 per cent, central nervous system tumours from 53 per cent to 84 per cent, bone tumours from 29 per cent to 72 per cent, germ cell tumours from 39 per cent to 94 per cent, melanoma and skin cancer from 64 per cent to 100 per cent, and carcinomas from 48 per cent to 80 per cent.
The findings also indicate that for all patients with cancer, survival was better for females than males and for patients aged 20 to 24 years compared with those aged 15 to 19 years. However survival was worse for patients who lived in more deprived areas.
In conclusion, this research shows that there have been large improvements in teenage and young adult cancer survival in Northern England over the last four decades.
Methodology
Data from the Northern Region Young Persons’ Malignant Disease Registry were analysed using Kaplan-Meier estimation and Cox regression. Five-year survival was analysed using Kaplan-Meier estimation for four successive time periods. Cox regression analysis was used to investigate associations with demographic factors.
The demographic characteristics of wards at each UK census from 1971 to 2001 were harmonised in terms of variable definition and geography to be comparable over time. These were used as explanatory variables in the statistical models. Townsend deprivation score for the census ward of residence was used to divide cases into five groups, from the most affluent to the most deprived. Townsend scores were based on 1971, 1981, 1991, and 2001 UK censuses estimated for 2001 census ward geography. Population density for each electoral ward was calculated by dividing the population by the area and wards were classified according to tertile of population density.
Publications
Basta, N.O., James, P.W., Gomez-Pozo, B., Craft, A.W., Norman, P. and McNally, R.J.Q. (2014) ‘Survival from teenage and young adult cancer in Northern England, 1968–2008’, Pediatric Blood & Cancer, 61, pp. 901–906. doi: 10.1002/pbc.24939