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Article: Adolescent cancer rising, and survival lagging
I received this through another list server, and
thought it might be of interest.
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Adolescent cancer rising, and survival lagging
3/1/04
By: Reuters Health
LONDON (Agence de Presse Medicale for Reuters Health),
Mar 1 -The incidence of cancer among people in their
in teens and early 20s is inexplicably rising while
survival has not improved for 25 years, British and
American researchers said on Monday.
Professor Jill Birch, from the University of
Manchester, who analyzed data on 13- to 24-year-olds
in England, said the cancer rate had risen from 15.4
to 19.8 per 100,000 between 1979 and 2000 - an average
increase of 1.2% a year.
The figures were released at the Teenage Cancer
Trust's Third International Conference on Adolescent
Cancer in London. Dr. Birch called for a specialized
system of cancer registration to be set up to unravel
the causes of cancer in this age group.
"What we need is a classification that is tailored to
the 13- to 24-year-olds with biologically similar
cancers classified together, and diagnostic categories
that allow maximum flexibility in analyses. A standard
classification that is accepted internationally will
ensure that results from different registries are
comparable."
Speculating on possible risk factors, she said: "The
early age of onset and lack of opportunity for chronic
exposure to environmental factors suggests that
genetic susceptibility may be important. Highly
penetrant genes or mutations probably only account for
a small proportion of cases. What is more likely is
that cancer develops as a result of exposure to a risk
factor in a genetically susceptible individual."
She said that the increasing incidence of certain
cancers over time would be consistent with
environmental risk factors becoming more frequent or
occurring at increasing levels. Alternatively,
lifestyle changes in recent years might also be
contributing.
Infection in early life could be important in
lymphoma. Passive smoking might also be a factor in
some cancers.
US cancer specialist Professor Archie Bleyer said
cancer survival among 15- to 29-year-olds had not
improved over the past quarter of a century -- a
striking failure relative to the 39-46% increase in
5-year survival of younger children.
Dr. Bleyer, who is Director of the Community Clinical
Oncology Program at the University of Texas MD
Anderson Cancer Centre in Houston, said psychological
factors could increase the risk of late diagnosis as
adolescents and young adults felt invincible and
tended to give poor information, especially to doctors
untrained in reading between the lines.
"Some of the most advanced diseases occur in
adolescents. We have older adolescents with
extraordinarily large masses of the breast, testes,
abdomen, pelvis and extremities that they've harbored
for months because they were too embarrassed to bring
the problem to anyone's attention," he said.
To improve survival, clinical trial participation
among 15- to 29-year-olds had to be increased. In the
U.S., it was under 1% in this age group - drastically
lower than the approximately 60% rate in younger
patients and the 3-5% in older patients.
By Richard Woodman
Last Updated: 2004-03-01 9:20:52 -0400 (Reuters
Health)
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+++++++++++++++++++
""A fanatic is one who cannot change his mind and won't change the subject." Winston Churchill
-- John
John Jacobus, MS
Certified Health Physicist
e-mail: crispy_bird@yahoo.com
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