The National Comprehensive Cancer Network® (NCCN®) has issued new NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Adolescent and Young Adult (AYA) Oncology. AYA patients are individuals 15 to 39 years of age at initial cancer diagnosis. The critical issues that AYA patients with cancer and their caregivers encounter at diagnosis, during treatment, and after therapy are addressed in the guidelines.
According to the American Cancer Society’s Cancer Journal for Clinicians, in the last 35 years, there has been minimal improvement in the survival rate for AYA patients diagnosed with invasive cancer.
“There is an urgent need for increased awareness of the many unique issues responsible for these poor outcomes in the AYA oncology patients,” said Peter F. Coccia, MD, of the UNMC Eppley Cancer Center at The Nebraska Medical Center, chair of the NCCN AYA Oncology Panel, and a member of the NCCN Board of Directors.
The NCCN Guidelines address the many factors responsible for the lack of results in the AYA patients. These include:
- Low clinical trial participation: In the United States, only about 10% of 15- to 19-year-old patients and 1%-2% of 20- to 39-year-old patients enroll in clinical trials
- Lack of health insurance: AYA patients often lack adequate health insurance They also may not have access to either routine health care, which leads to earlier diagnosis, or to state-of-the-art care once diagnosed
- Resistance: AYA patients tend to be less compliant with their prescribed treatments
The NCCN Guidelines Panel advises that AYA patients be referred to cancer centers with expertise and experience in treating AYA patients and the cancers that affect them. Recommendations for fertility preservation; screening recommendations for late effects after successful completion of therapy; palliative care and end-of-life considerations for patients who fail curative therapy; and online resources for AYA patients and cancer survivors are included in the NCCN Guidelines.
Bradley J. Zebrack, PhD, MSW, MPH, of the University of Michigan Comprehensive Cancer Center, a member of the NCCN AYA Oncology Panel, says, “Managing these patients medically and communicating effectively with them can be challenging, and requires that the full team of healthcare providers be knowledgeable about adolescent behavior. The team must also be well trained in how to communicate with teens and young adults, as well as their families and peers.”
Source: NCCN.