Portland, Ore.

Researchers at Oregon Health & Science University and two other institutions have found a way to better predict the survival of older adolescents and young adults with cancer. They calculated a new statistic called conditional survival, which takes into account the time elapsed since diagnosis when predicting survival probability. The research was presented during the American Society for Therapeutic Radiology and Oncology, which runs through Nov. 9 in Philadelphia by Samuel J. Wang, M.D, Ph.D., Holman Pathway resident in radiation medicine.

"Traditionally, cancer survival rates are usually only reported from the time of diagnosis, but for patients who survive several years after diagnosis and treatment, survival rates may change and often improve," said Wang.

The researchers used the National Cancer Institute's Surveillance, Epidemiology and End Results database to determine the conditional survival rates of cancer patients between the ages of 15 and 29, and compared them with younger and older age groups.

In prior studies, Wang had found that in other age groups, conditional survival rates improved significantly as patients survived longer periods of time from their diagnosis and treatment. In this latest study, however, they found that patients in the 15-to 29-year-old age group showed the least improvement in conditional survival over time, compared with every other age group, including infants and patients older than 85.

"This information on conditional survival rates is useful to patients who want to know how their current prognosis is changing from year to year.  It is also useful information for health care providers who need to decide on appropriate follow-up testing based on the patient's risk," Wang said.

The reason young adults show the lowest improvement in conditional survival rates is not known. It could be due to the unique mix of cancers in this age group, which predominantly consist of lymphomas, melanomas and testicular and thyroid cancers. It could also be because this age group has historically received less attention in cancer research compared to other age groups.  This age group has the lowest enrollment rate in clinical trials despite the fact that cancer is 2.7 times more common in this age group compared with those younger than 15 year. Wang suggests that further studies are needed to investigate other potential causes for these findings.

Charles Thomas, M.D., professor and chairman of the radiation medicine in the OHSU School of Medicine and a member of the OHSU Cancer Institute; researchers at University of Texas Health Science Center, San Antonio, TX, and St. Charles Medical Center in Bend Ore., participated in the study.

OHSU Cancer Institute is home to one of the first Adolescent and Young Adult Oncology Programs in the country. The AYA's mission is to develop and disseminate more effective methods to diagnose, treat, follow, and care for young adults with cancer aged 15 to 40.
 
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The OHSU Cancer Institute is the only cancer center designated by the National Cancer Institute between Sacramento and Seattle. It comprises some 120 clinical researchers, basic scientists and population scientists who work together to translate scientific discoveries into longer and better lives for Oregon's cancer patients. In the lab, basic scientists examine cancer cells and normal cells to uncover molecular abnormalities that cause the disease. This basic science informs more than 200 clinical trials conducted at the OHSU Cancer Institute.