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NCCN Guidelines for Patients


Adolescents and Young Adults with Cancer, Version 1.2017

What should I know about AYAs?

It’s estimated that only 5 out of a 100 of cancer

cases in the U.S. are diagnosed in people between

15 and 39 years of age. Yet cancer is the leading

cause of death among AYAs (

See Figure 3

). While

many of the cancers diagnosed in AYAs are treatable

and even curable, survival rates for AYAs have not

improved over time. The survival rates are better for

young children and older adults with cancer.


1. One reason is that younger people may go to the

doctor less often, so early signs of cancer are

more likely to be missed. Teens and young adults

who have little or no health insurance are unlikely

get regular health tests that might detect cancer

before it has spread.

2. Doctors may not be familiar with treating AYA

patients. AYAs bodies are still developing and this

group needs special attention when it comes to

cancer care. It is important that AYAs seek out a

doctor that specializes in treating young adults.

3. A low number of AYAs participate in clinical

trials. Clinical trials are research studies that can

help find new or better ways to treat cancer. If

more AYAs join clinical trials, there may be more

advances in cancer treatment for this age group.

4. Both young adult males and females develop

different types of cancer than older adults. These

cancers often have different mutations and

behave very differently than the same cancers in

children and older patients.

For example:


Women younger than age 40 who develop

breast cancer are more likely to have a family

history of the disease. These women are more

likely than older women to develop tumors

that do not respond to hormone therapy.


Sun exposure is less likely to cause

melanoma in young adults. It also tends to be

less severe than melanoma in older people.


Young adults with colorectal cancer are more

likely to have inherited mutation and disease

that grows or spreads quickly.

Cancer treatment in AYAs can be complicated by the

fact that their bodies are still developing. Young adults

are going through physical and hormonal changes

that affect not only how cancer develops, but also

how the body responds to cancer treatments.

On the plus side, younger patients often have

fewer medical conditions, which means they can

tolerate treatment that is more intense than usual

(aggressive). Older patients may not be able to

tolerate this intense treatment.

Treatment options will vary for young adults based on

the unique needs of AYAs. In fact, young adults with

cancer can join a clinical trial to learn more on how

treat this age group. More on that topic in Part 5.


But I'm too young to have cancer!

What should I know about AYAs?