Page 16 - Delaware Medical Journal - November/December 2020

Figure 1-1 Five-Year Average, Age-Adjusted All-Site Cancer Incidence Rates by Sex and Race/Ethnicity; U.S. and Delaware, 2011-2015
Source (Delaware): Delaware Department of Health and Social Services, Division of Public Health, Delaware Cancer Registry, 2018. Source (U.S.): Surveillance, Epidemiology and End Results Program (SEER 18), National Cancer Institute, Nov 2017 Sub.
Rates are per 100,000 of population age-adjusted to the 2000 U.S. standard population.
include consultations with AYAs to gain insight into their desires and preferences for medical care, a physical space dedicated to AYAs, and a team concerns such as fertility counseling, psychosocial support, supportive care, and survivorship support.9
Poor Clinical Trial Enrollment
The majority of pediatric cancer patients are enrolled in clinical trials, as they often are treated at institutions that participate in trial enrollment.2 On the other hand, AYA patients are more likely to present to adult institutions, where enrollment in clinical trials has
2 This may be due to limited access to clinical trials, poor knowledge on behalf of the provider about available trials, and varying patient factors limiting access to care.2,9 Efforts have been
made to improve enrollment among AYA patients, including expanding age eligibility on more clinical trials and expanding access to community-based clinical trials.2 Despite those efforts, a number of studies have evaluated AYA participation in trial enrollment, most of which have reported consistently low overall participation.2 Enrolling patients in clinical trials is important because
it helps identify new therapeutic
approaches, improve existing regimens, and supports researchers in learning about differences in patient and cancer biology.10
Unique Psychosocial Needs
While tailoring cancer treatment approaches for AYA patients is vital,
it is equally important to understand their unique psychosocial needs. Many social, emotional, and developmental transitions take place during the period from adolescence to young adulthood. Therefore, a cancer diagnosis during that time may lead to a disruption in these major life events.3 For instance, education is often interrupted during
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Del Med J | November/December 2020 | Vol. 92 | No. 6