1409P - When and why do teenage and young adult oncology patients die early in the cancer pathway?

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Cancers in Adolescents and Young Adults (AYA)
Bioethics, Legal, and Economic Issues
Presenter Elaine Dunwoodie
Citation Annals of Oncology (2014) 25 (suppl_4): iv486-iv493. 10.1093/annonc/mdu353
Authors E. Dunwoodie1, V.E. Watkins2, M.E. Lane3, M.-. van Laar4, R. Phillips5, G. Hall1, D. Stark1
  • 1St James's Institute Of Oncology, St James's University Hospital, LS9 7TF - Leeds/GB
  • 2Fy1 Doctor, Calderdale and Huddersfield NHS Trust, HD3 3EA - Huddersfield/GB
  • 3Fy1 Doctor, The Mid Yorkshire Hospitals NHS Trust, WF1 4DG - Wakefield/GB
  • 4Division Of Epidemiology And Biostatistics, Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, LS2 9JT - Leeds/GB
  • 5Centre For Reviews And Dissemination, University of York, YO10 5DD - York/GB



Teenage and young adult (TYA) oncology patients fall between adult and paediatric services. Recent data has revealed early deaths in TYAs. Amongst adults, early deaths are a proxy measure for late stage presentation or treatment delay, whereas amongst children early deaths are often treatment-related. In TYA patients the cause of early deaths remains unknown. We aim to examine early deaths and whether they are related to anti-cancer therapy.


We analysed population based Northern and Yorkshire Cancer Registry and Information Service data of all patients aged 13-24 years inclusive at cancer diagnosis (n = 1137), over 12 years to 31/12/2011. We used morphological classification, descriptive statistics, cox regression models and death certificate review to examine patterns and causes of death, within one year of diagnosis.


Of 1137 TYAs, 95 died within 12 months of diagnosis (45% of all deaths). Most of these deaths were between 90 and 365 days. Only patients with leukaemias, non-Hodgkin's lymphoma, central nervous system tumours and soft tissue sarcomas (STS) died within 30 days. Highest risk of mortality within one year was in acute lymphoblastic leukaemia (HR 1.86, p = 0.039), STS (HR 2.38, p = 0.004) and gastric carcinoma (HR 10.86, p < 0.001) with germ cell tumours as a comparator. The cancers with the greatest proportion of deaths within one year were gastric carcinoma (60.0%), liver and intrahepatic carcinoma (21.4%), STS (20.0%) and acute myeloid leukaemia (AML) (19.1%). Only 4 of the 95 deaths within one year had cancer treatment or definite consequence of it, recorded on the death certificate.


The highest incidence of deaths in TYA cancer patients is in the first year after diagnosis. One year mortality varies according to cancer diagnosis. Very few deaths are attributed to anti-cancer therapy. Reducing one year death rate, in STS and AML particularly, may contribute to improving survival in TYA cancer patients.


All authors have declared no conflicts of interest.