Adolescents and young adults with cancer in Switzerland: a large single-centre analysis of key care pathways and outcomes by sex and age

Abstract

Background Adolescents and young adults with cancer (AYA) represent a distinct patient group with unique challenges. Most studies reporting outcomes use registry data, leaving local care aspects underreported.

Aim To understand demographic and clinical characteristics of AYA patients focusing on variations by cancer type, sex, and age, as well as fertility preservation, palliative care, clinical trial participation, and survival outcomes.

Methods A retrospective single-centre study examined electronic medical records of AYA patients (age 15–39 years) treated for their initial diagnosis of cancer at University Hospital Bern (Inselspital) in the period 2015 -2021. Descriptive statistics summarized patient characteristics, and Kaplan-Meier survival curves and logistic regression were used for survival prediction.

Results The AYA cancer cohort consisted of 395 patients (67% male) with a median age of 27. Testicular cancer and Hodgkin lymphoma were the commonest diagnoses (24% and 25% respectively), followed by non-Hodgkin lymphoma (11%), leukaemia (11%), and central nervous system tumours (11%). The median time from diagnosis to first treatment was 13 days. Clinical trial participation was 29% and 58% attended fertility consultations with higher rates among males (61%) than females (50%). Five-year survival for the entire cohort was 84%; lower in older patients and those with metastatic disease.

Conclusion This study provides the first Swiss dataset on AYA cancer patients at a tertiary centre. While survival rates were high, disparities existed by diagnosis and metastatic status. Further research is needed to enhance survival in specific cancers and improve palliative and fertility care.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This study did not receive any funding

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The Cantonal Ethics Committee of Bern, Kantonale Ethikkommission Bern, waived approval for this study, 2022 00474.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

Data in the present study are available upon reasonable request to the authors.

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