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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)







=====

+++++++++++++++++++

""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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