Epidemiology of adolescents and young adult cancers in National Institute of Cancer Research and Hospital, Dhaka

Abstract

Objectives: Cancers in adolescents and young adult (AYA) are increasing day by day but there are few clinical and epidemiological data from developing country. The objectives of the study were to find out disease patterns of cancers in AYA, their relation with age group, sex ratio, and histology. Material and Methods: The study was an observational study. All histologically confirmed cancer patients aged 15–39 years registered in NICRH from January 2016 to December 2016 (12 months) were included. The patients were grouped according to Birch classification of AYA cancer. Each patient was interviewed and clinical information and demographic profiles were recorded. Clinical information was retrospectively studied. Results: A total of 400 patients were enrolled for this study. Of them, male (M) was 277 (69.25%), female (F) was 123 (30.75%) and male female ratio was 2.25:1. Younger AYA patients (15–19 years) were most common, 126 (31.50%). Then, next common was young adult (35–39 years), 102 (25.50%). Remaining age group patients 20–24 years, 25–29 years, and 30–34 years group were 50 (12.50%), 57 (14.25%), and 65 (16.25%), respectively. The six most common cancers were germ cell tumor (GCT) and trophoblastic tumor 64 (16%), lymphomas 63 (15.75%), osseous and chondromatous neoplasm 63 (15.75%), soft-tissue sarcoma (STS) 55 (13.75%), leukemia 50 (12.50%), and gastrointestinal tract (GIT) carcinoma 46 (11.5%). The most common cancers in younger AYA (15– 19 years) were osseous and chondromatous neoplasm 38 (30.16%), leukemia 27 (21.43%), STS 26 (20.63%), and in contrast, older AYA (35–39 years) suffered mainly from lymphoma 21 (20.59%), GIT carcinomas 20 (19.61%), and GCT and trophoblastic tumor 19 (18.63%). The leading cancers in 20–24 years aged group were bone tumor 12 (24%), GCT and trophoblastic tumor 12 (24%), and STS 9 (18%); 25–29 years aged group were lymphoma 10 (17.54%), STS 9 (15.79%), and GIT malignancy 9 (15.79%); 30–34 years aged group were GCT and trophoblastic 21 (32.31%), lymphoma 15 (23%), and GIT cancer 8 (12.31%). The leading presenting features were swelling 177 (44.25%), pain 122 (30.50%), fever 110 (27.5%), vomiting 65 (16.25%), loss of appetite 60 (15%), and bleeding manifestations 30 (7.5%). Majority 146 (36.50%) were educated up to primary, 50.50% of patients belongs to low socioeconomic status, 25.25% was student, 64.50% was rural dweller, and 39.50% and 33.00% presented with Stage iv and Stage iii, respectively, among them 47.75% with performance status Grade 2 according to Eastern Cooperative Oncology Group. Conclusion: In AYA, the six most common cancers were GCT and trophoblastic tumor.