Introduction: Teenagers and young adults


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Jeremy Whelan
University College London, UK

Abstract

There is increasing international recognition that teenagers and young adults (TYA), broadly those aged 13-24 years, deserve specific attention to meet a set of unique needs. This period of intense personal change and development brings additional challenges to dealing with a cancer diagnosis. Neither adult nor paediatric cancer services are designed to address the range of specific disease-related and age-related needs of TYA. On the other hand, specialist services are incompletely developed so that access and delivery is patchy. Regrettably, there is a lack of high-quality research-based evidence to encourage paediatric and adult clinical communities to adopt a patient-orientated approach to TYA cancer care. Critically, and perhaps as a consequence, improvements in survival for TYA with cancer have lagged behind those observed in children and older adults. A prolonged period to diagnosis, poor entry to clinical trials, and differences in cancer and host biology are all thought to be contributing factors.

The UK is at the forefront of TYA cancer care, with service change being driven by the National Institute for Health and Clinical Excellence Guidance, Improving Outcomes in Children and Young People with Cancer. Key recommendations reflect age-specific needs, and suggest unhindered access to age-appropriate care and access to a broader range of TYA professional expertise. As TYA cancer care emerges as a speciality, the international community are looking to the UK to provide evidence of the outcomes associated with such care.

The panel will discuss how far we have come and what challenges remain in measuring the outcomes that may be associated with specialist care, the influence of age, gender and clinical trial entry. Pivotal to the development of meaningful and relevant research, young people themselves will discuss their research priorities for cancer.