Epidemiology

Teenage and young adults (TYA) refer to people aged between 16 and 24 years. In 2010, 2214 TYA were diagnosed with cancer and 311 died of the disease. The types of cancers that occur in TYA differ from those seen in childhood and adulthood (see Tables 1.1 and 35.1). Survival has steadily improved over recent decades so that over 80% TYA with cancer survive 5 years or more from their cancer diagnosis.

Presentation and management of paediatric solid tumours

The clinical presentation and routes to diagnosis of cancer in TYA differ from those for children and adults. Around a quarter of cancers in TYA are diagnosed via an emergency admission, although this rate varies with tumour type. For example, only 2% melanomas in TYA are diagnosed as an emergency whilst over 50% of leukaemias are diagnosed in an emergency department. In contrast, 54% of children with cancer present as an emergency but only 15% of adults present in this way.

The major difference in the management of cancer in TYA relates to the way the service has been delivered in the United Kingdom since 2008. Treatment of TYA with cancer is confined to designated treatment centres providing age-appropriate facilities. Although the clinical management plans remain with tumour site-specific multi-disciplinary teams (MDTs), this should be in joint collaboration with a TYA MDT based at one of 13 principal treatment centres for TYA with cancer in the United Kingdom.

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Case Study: The fainting dancer.