Cancer-in-Adolescents-and-Young-Adults在青少年與年輕成人癌癥課件

1、Elias Ghandour, M.D. F.A.C.P., F.A.C.G., P.A.Fellow of the American College of PhysiciansFellow of the American College of GastroenterologyMember of the American Association for the Study of Liver DiseaseClinical Associate ProfessorTTUHSC Lubbock, Texas USACancer in Adolescents and Young AdultsCance

2、r in Adolescents and Young Adults (15-29)Largely understudiedAwareness of the cancer in this age group is less than in older adultsRelatively infrequentEpidemiology and SurveillanceTransition between more non epithelial types (acute leukemia and embryonal tumors) and epithelial types (carcinoma).The

3、refore, they are blends of childhood and adult cancersLeading Types of Cancer Among Young Women (15-29 Years) Percentage of New Cases, Canada, 1992-2019 Thyroid 19%Hodgkin Lymphoma 13%Melanoma 11%Cervix 9%Other epithelial 8%Other Non-epithelial 7%Canadian Cancer Society, Canadian Cancer Statistics 2

4、009Leading Types of Cancer Among Young Women (15-29 Years) Percentage of New Cases, Canada, 1992-2019Breast 7%Leukemia 6%Central Nervous System 6%Non-Hodgkin Lymphoma 5%Soft Tissue and Other Extraosseous Sarcoma 4%Ovary 4%N=15, 043Canadian Cancer Society, Canadian Cancer Statistics 2009Leading Types

5、 of Cancer Among Young Men (15-29 Years)Percentage of New Cases, Canada, 1992-2019Germ Cell Testis 24%Hodgkin Lymphoma 14%Non-Hodgkin Lymphoma 10%Other Epithelial 10%Leukemia 8%Canadian Cancer Society, Canadian Cancer Statistics 2009Leading Types of Cancer Among Young Men (15-29 Years)Percentage of

6、New Cases, Canada, 1992-2019Central Nervous System 8%Melanoma 7%Soft tissue and Other Extraosseous Sarcoma 6%Thyroid 5%Bone 4%Other Non-epithelial 3%N=14,005Canadian Cancer Society, Canadian Cancer Statistics 2009Causes Life Related ChangesEducationEmploymentPersonal relationCommon CancersLymphomasH

7、odgkins and non-HodgkinsMost common non-epithelial cancerHigher incidence in males than females, especially non-HodgkinsThyroid CancerEpithelial cancerMost common young femalesMelanomaMore common in femalesGerm Cell Testis CancerNon-epithelial typeHighest incidence among all male cancer 24%LeukemiaM

8、ost common cause of deathMale 21%Female 17%Prevention and ScreeningLittle is known about risk factorsCongenital AnomaliesUndescended testicleFamily History of CancerTestisBreastColorectalInfection AgentsHPVHIV virusEpstein Barr virusEnvironmental ExposuresUV radiationWar zonesPreventionPrimary preve

9、ntion is limitedOrganized cancer screening is ineffectiveRare cancersShort latency period and aggressive growthCervical CancerPap smear is effective for diagnosisPopulation screening is recommended Decrease incidence and mortalityPap smear should be recommended to all sexually active women of all ag

10、esUse of the HPV vaccine for females age 9-26Modification of Life StyleTobaccoAlcoholDrugsSexual ActivityPotential Years of Life Lost Due to Cancer, Canada, 2019Potential years of Life Lost (PYLL)TotalMalesFemalesYears %Years %Years %All Cancers1,026,600 100495.000 100531,700 100Age Group0-1410,2001

11、.05,200 1.15,000 0.915-194,1000.42,500 0.51,600 0.320-245,4000.53,100 0.62,300 0.425-296,5000.63,400 0.73,200 0.630-3933,4003.313,900 2.819,500 3.740-49115,70011.348,700 9.867,100 12.650-59225,40022.0104,000 21.0121,400 22.860-69260,40025.4134,000 27.1126,400 23.870-79244,40023.8126,700 25.6117,700

12、22.180+121,10011.853,500 10.867,600 12.7Canadian Cancer Society, Canadian Cancer Statistics 2009Estimated Observed Survival Proportion (95% Confidence Interval) for Selected Cancers in Adolescents and Young Adults (15-29) by Survival Duration, Canada, 2019-2019 Observed Survival Proportion (%) (95%

13、Confidence Interval)1-year3-year5-yearAll CancersThyroid93 (93-94)86 (85-87)83 (82-84)Testis100 (99-100)99(99-100)99 (99-100)Hodgkin Lymphoma99 (98-99)96 (95-97)96 (94-97)Melanoma99 (98-99)96 (94-96)94 (93-95)Cervix98 (97-99)95 (94-96)92 (91-94)Non-Hodgkin Lymphoma96 (94-97)88 (85-90)86 (83-88)Breas

14、t84 (82-86)76 (73-78)74 (71-77)Soft Tissue and Other 97 (95-98)83 (80-86)73 (69-77) Extraossesous Sarcoma89 (86-91)76 (73-79)72 (69-76)Central Nervous System88 (86-90)75 (72-77)66 (63-69)Leukemia81 (78-83)66 (63-69)61 (58-64)Canadian Cancer Society, Canadian Cancer Statistics 2009Estimated 5-Year Ob

15、served Survival Proportion (95% Confidence Interval) for Selected Cancers in Adolescednts and Young Adults (15-29), by Sex and Age Group, Canada 2019-2019Observed Survival Proportion (%)(95% Confidence Interval )1 yr3 yr5 yrALL CANCERS93 (93-94)86 (85-87)83 (82-85)Thyroid100 (99-100)99 (99-100)99 (99-100)Testis99 (98-99)96 (95-97)96 (94-97)Hodgkin Lymphoma99 (98-99)96 (94-96)94 (93-95)Melanoma98 (97-99)95 (94-96)92 (91-94)Cervix96 (94-97)88 (85-90)86 (83-88)Non-Hodgkin Lymphoma84 (82-86)76 (73-79)74 (71-77)Breast