Older adolescents with cancer in North America Deficits in outcome and research

The epidemiological, medical, physical, psychological and social needs of older adolescents with cancer have not received the same attention as has been focused on younger patients with malignant disease. The improvement in survival among adolescents with cancer has been a fraction of the rate of improvement in the younger age groups. Survival rates of older adolescents with cancer in the general population have not had comparable improvement, especially in comparison with results of the national pediatric cooperative cancer groups. In the United States and Canada, only about 5% of 15 to 25 year-olds with cancer are entered onto clinical trials, in contrast to 60% to 65% of younger patients. Thus, cancer during adolescence and early adulthood has been relatively neglected and merits enhanced national research programs and resources.