Trends in the incidence and survival of cancer in teenagers and young adults: regional analysis for South East England 1960-2002.

AIMS: This study aimed to describe trends in the incidence and survival of cancer in teenagers and young adults in South East England between 1960 and 2002, and the influence of socioeconomic status upon survival. MATERIALS AND METHODS: Data on 1788 patients aged 15-24 years were extracted from the Thames Cancer Registry, assigning each to a diagnostic group using the Birch and Marsden classification. Age-specific incidence rates in 5-year periods for the age groups 15-19 and 20-24 years were calculated for each diagnosis. Five-year relative survival estimates by diagnostic group were calculated for both age groups using 5-year periods of follow-up and non-overlapping years of diagnosis. To calculate overall survival estimates by socioeconomic group, the 10-year follow-up period 1993-2002 was used. RESULTS: Overall incidence rates were 162 per million person-years in 15-19 year olds and 261 in 20-24 year olds. We found a higher overall incidence in males, in 20-24 year olds and an increasing incidence over the last four decades, particularly in this age group. In both the 15-19 and 20-24 years age groups lymphomas were most common. The 5-year relative survival improved for all diagnostic groups, except bone tumours in the older age group, particularly for leukaemia and slightly more for the 20-24 than 15-19 years age group. Teenagers aged 15-19 years and living in more deprived areas had a significantly lower survival than those in more affluent areas. CONCLUSIONS: These findings confirm the increased incidence and improved outcome of cancer in teenagers and young adults. Future analyses should investigate trends in bone tumour survival across regions, survival by socioeconomic status and the influence of specialised care on further improvements in survival.