Adolescents and young adults
As a group, young people aged 15-24 accounted for 14% of the population in Australia in 20069.
The most common cancers affecting AYA (aged 15-29) in the period from 2003-2007 were melanoma (26% of all cancers), gonadal germ cell cancers (13%), and Hodgkin lymphoma (10%).10
In the period 2004 – 2010, five-year relative survival for AYA diagnosed with cancer was 88%, which was significantly increased from 80% in 1983 – 1989.10
Cancer remains one of the leading causes of death among young Australians.9 In the period 2003 – 2007:10
- there were 1,018 cancer deaths in AYA, comprising 9.2% of all deaths in this age group
- the leading causes of cancer death were brain cancer, bone cancer and melanoma of the skin.
Adolescence is a time of dramatic change in physical growth, awareness of body image, and concepts of personal and social self.11 AYA affected by cancer have numerous additional challenges and require specific psychological and social support throughout their cancer journey.
The uncertainty, self-consciousness, emotional reactivity and still developing cognitive abilities of AYA, combined with their increased exposure to risky situations, makes diagnosis particularly difficult during this life stage. AYAs need individualised care plans that recognise individual diagnoses, circumstances, and developmental stages.12 Working with AYA affected by cancer necessitates focusing on how normal life can be maintained while minimising psychological distress.13
Reactions to diagnosis of cancer in AYA are complex and affected by family relationships, culture, chronological and psychological development. Any care provided must be multi-dimensional and incorporate the needs of the family. While there is limited research about the needs of AYA families specifically, there is some evidence that cancer affects the whole family and that family members can experience significant distress.14
The increased demands on family associated with the high care needs of a person with cancer can result in restricted social relationships, work and other responsibilities and practical problems related to disease management and finances.14
Generally, there is a lack of awareness in the AYA population and primary health care providers of signs and symptoms for early diagnosis of cancer in this group. Developmental, psychological and social factors may place AYA at higher risk of a delay in diagnosis.15
Figure 2: The '7 symptoms' increase awareness of early clues to cancer diagnosis in AYA.16 (Permission to reproduce images provided by author).
Cancer Australia. (2015) EdCaN module: Osteosarcoma case based learning resource.
Watch Justin’s story: dealing with diagnosis as he describes his reaction to a diagnosis of osteosarcoma. You may also wish to access the Adolescent and Young Adult Cancer National Service Delivery Framework17. (PDF, 1.07MB) Complete the following learning activity:
- Describe Justin’s key health and support needs now and into the future.
Access the Adolescent and Young Adult Cancer National Service Delivery Framework(PDF, 1.07MB)17, and outline the implications of this Framework for Specialist Cancer Nurses involved in the care of AYA.