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Teens see slower rise in cancer survival rates than other age groups

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Adolescents and young adults with cancer in Ireland are not seeing the same increase in survival rates for the disease as children and older groups, it emerged yesterday.

A new HSE document shows cancer is the leading cause of death in 16-24 year olds, with 180-190 annual cases of the disease among this age group.

It suggests the slower improvement in survival could be linked to various factors including poor medication adherence, low enrolment in clinical trials, issues related to puberty and complex psychological factors.

The particular difficulties facing this age group were highlighted as the HSE launched a framework plan for 2021-2026 to improve their treatment and hospital experience.

Professor Owen Smith, a cancer specialist and National Clinical Lead for Children, Adolescent and Young Adult Cancers in the HSE, said: “Adolescent and young adult (AYA) patients constitute a unique group that deserves special attention.

“Although there is marked variability between the definitions of AYAs, ranging from 15-20 to 15-39 years, cancer continues to be the leading disease-related cause of death in this population.

“AYAs with cancer are a diverse group as defined not simply by their age and distinct biology of their cancer, but in terms of the challenges they face with regards to adequate access to age-appropriate oncological care, representation on clinical trials, short and long-term health and psychosocial issues that include fertility considerations, transition to survivorship care, psychosocial support, adherence to treatment difficulties and other dilemmas and problems exclusive to this group of patients.

“The framework succinctly outlines strategies to coordinate state-of-the-art integrated AYA care to be delivered locally when possible but centralised when necessary by providing separate facilities and specialist care teams for these patients.

"Once this has been achieved, the challenge will then be to secure the future through education, research/innovation and future service developments. The ultimate aim of the framework is to improve the standards and quality of cancer care provided to AYAs and at the same time define outcome measures of high-quality care for AYA patients across the proposed AYA cancer network as outlined in the National Cancer Strategy.”

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The framework aims to see “a state-of-the-art” cancer care network for this age group delivered locally where possible. It will be centralised when necessary by providing separate facilities and specialist care teams in the new children’s hospital and three of the eight adult designated cancer centres around the country.

The three new national AYA cancer units will be based at St James’s Hospital, University Hospital Galway and Cork University Hospital. These units will bring together all the relevant experts and allow this collective knowledge, experience and interest to work towards better experiences, better outcomes and better long-term quality of life.

The HSE said cancer is “a major health problem for the older adolescent and young adults. It is the leading cause of natural death in this population, with approximately 30pc due to haematological malignancies”.


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