Cancer survival soars for the under-25s

3 minute read

While Australian mortality rates have stayed steady for 30 years, more than double the rate of teens and young people are surviving.

Deaths from cancer among adolescents and young adults have more than halved since the 1980s, but cancer remains the second biggest killer after injury, according to new Australian data.

The good news appears to be largely driven by better blood cancer survival, but is tempered by the ballooning rates of colorectal, thyroid and chronic myeloid cancer in this group. 

Hodgkin lymphoma is now the most common cancer in people aged 15 to 24, making up 13% of all cancer cases, according to the Australian Institute of Health and Welfare’s latest report.

That’s followed by skin melanoma at 12%, testicular germ cell cancers (12%), thyroid cancer (11%) and colorectal cancer (10%).

Since the early 1980s, the mortality rate from all cancers has fallen from 62 deaths per one million down to 29 deaths per one million in the late 2010s. Mortality rates also increase with age.

“Mortality rates have been consistently higher for males than females, however the gap between the sexes has decreased over time,” the AIHW report said.

“While both sexes have experienced a decrease in mortality since 1981-1985, the decrease has been greater for males.”

The report said there was likely to be several reasons for the decrease in mortality, such as sun safety campaigns and improvements in cancer detection, treatments and prevention.

But while mortality rates have fallen, the rates of all cancers in young people aged 15 to 24 have remained steady over the last 30 years, at around 315 to 335 cases per one million.

Between 1984 and 2013, melanoma was the most common cancer in young people, but it’s now the second most common after Hodgkin lymphoma.

During the 30 years up to 2018, the rates of colon and rectum cancer quadrupled in young people, from nine to 33 cases per one million. Rates almost tripled for thyroid cancer and chronic myeloid cancer and doubled for mature non-Hodgkin lymphoma.

But for cervical cancer, cancer of the head and neck and melanoma of the skin, the incidence more than halved during that period.

For people aged 15 to 24, five-year survival for all cancers rose from 79% to 90% in the 20 years to 2018.

“The increase in survival for all cancers combined has been largely driven by improved relative survival for blood cancers,” the report said.

“Bone cancer and central nervous system cancer were the leading causes of cancer death among people aged 15–24, followed by soft tissue sarcoma, acute lymphoblastic leukaemia/lymphoma, and acute myeloid leukaemia,” the report said.

“Mortality tended to increase with age, however, people aged 15–24 had higher mortality rates than people aged 25–39 for acute lymphoblastic leukaemia and bone cancer.”

Bone cancers and central nervous system cancers were the largest causes for cancer death in 2013-2017, causing 17% of deaths each, while sarcomas caused 15% of deaths.

In 2020–21, there were 11,300 hospitalisations of young people for cancer treatment, and 70% of those were same-day admissions. There were also 37,000 services at hospital outpatient clinics during that period.

According to the report, the cancers most commonly associated with hospital admission were acute lymphoblastic leukaemia (16%), Hodgkin lymphoma (14%) and bone cancer (11%), followed by testicular cancer for males and acute myeloid leukaemia for females.

Young people who have had cancer also have a higher risk of developing a second primary cancer, at a rate 1.9 times higher than the general population.

Among people who went on to develop a subsequent cancer, about 20% had previously had Hodgkin lymphoma, followed by melanoma (19%), testicular germ cell cancer 8% and thyroid cancer (6%).

AIHW 2023: Cancer in adolescents and young adults in Australia

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