The document discusses adolescents and young adults with cancer, focusing on their treatment and transition to adult oncology care. It notes that this age group has among the highest cancer incidence rates, poorest health outcomes, and faces unique psychosocial challenges. Specifically, it finds that they have lower rates of health insurance, experience more delayed diagnoses, receive suboptimal treatment dosing, and have worse survival rates than pediatric or older adult cancer patients. The document also examines barriers to appropriate care during the transition period and possible solutions such as establishing healthcare transition teams and increasing education for adult providers.

1. ADOLESCENTS AND YOUNG ADULTS WITH CANCER TREATMENT AND TRANSITION TO AN ADULT ONCOLOGY ENVIRONMENT David J Friedman MD. PH.D

2. Copyright ©2007 American Cancer Society From Bleyer, A. CA Cancer J Clin 2007;57:242-255. FIGURE 1 Incidence of Invasive Cancer by Individual Year of Patient Age at Diagnosis and by Gender, US SEER, 1973 to 2003

3. Copyright ©2007 American Cancer Society From Bleyer, A. CA Cancer J Clin 2007;57:242-255. FIGURE 6 Change in 5-year Relative Survival from 1975 to 1980 to 1993 to 1997 by Age at Diagnosis, All Invasive Cancer, US SEER

4. Copyright ©2007 American Cancer Society From Bleyer, A. CA Cancer J Clin 2007;57:242-255. FIGURE 10 Cancer Mortality Rate by Age at Death and Era, United States, 1975 to 2003

5. Copyright ©2007 American Cancer Society From Bleyer, A. CA Cancer J Clin 2007;57:242-255. FIGURE 8 Cancers with 5-year Relative-survival Rates That Are Lower in Adolescents and Young Adults Than in Younger Patients, US SEER, 1993 to 1997

6. Copyright ©2007 American Cancer Society From Bleyer, A. CA Cancer J Clin 2007;57:242-255. FIGURE 7 Cancers with 5-year Relative-survival Rates That Are Lower in Adolescents and Young Adults Than in Younger and Older Patients, US SEER, 1993 to 1997

8. Copyright ©2007 American Cancer Society From Bleyer, A. CA Cancer J Clin 2007;57:242-255. FIGURE 2 Incidence of All Invasive Cancer by Race/Ethnicity and Age at Diagnosis, Age Younger Than 45 Years, US SEER, 1990 to 2003

12. Copyright ©2007 American Cancer Society From Bleyer, A. CA Cancer J Clin 2007;57:242-255. FIGURE 4 Relative Incidence of the Most Frequent Types of Invasive Cancer in 15- to 29-year-olds, US SEER, 1992 to 2000

13. Copyright ©2007 American Cancer Society From Bleyer, A. CA Cancer J Clin 2007;57:242-255. FIGURE 9 US National Annual Cancer Mortality Rate by Calendar Year for Ages Younger Than 15 Years, 15 to 19 Years, 20 to 24 Years, and 25 to 29 Years at Diagnosis

14. Copyright ©2007 American Cancer Society From Bleyer, A. CA Cancer J Clin 2007;57:242-255. FIGURE 3 Incidence of Invasive Cancer by Calendar Year and Age at Diagnosis, Age Younger Than 30 Years, US SEER, 1993 to 2003

18. Copyright ©2007 American Cancer Society From Bleyer, A. CA Cancer J Clin 2007;57:242-255. FIGURE 5 Estimated Proportion of Newly Diagnosed Cancer Patients Accrued to National Treatment Trials by Patient Age at Study Entry, 1997 to 2003

19. Copyright ©2007 American Cancer Society From Bleyer, A. CA Cancer J Clin 2007;57:242-255. FIGURE 11 Accruals to US National Cancer Treatment Trials, 2003 to 2005 Versus 2000 to 2002

36. ADDITIONAL BARRIERS TO APPROPRIATE CARE

45. Copyright ©2007 American Cancer Society From Bleyer, A. CA Cancer J Clin 2007;57:242-255. FIGURE 12 Accrual of <40-year-olds to National Sarcoma Treatment Trials by 2-calendar-year Intervals, 1998 to 2005, According to <15-year (Green) and 15- to 39-year (Red) Age Groups