Few Cancer Studies Focus on Teens, Young Adults

If more teens and young adults with cancer took part in clinical trials, it might improve that age group’s chances of survival.

Recent years have seen significant improvement in cancer survival. But researchers say that young adults have had less improvement than children or older adults. To test this further they looked at people with cancers called sarcomas, which are cancers of bone, muscle, or cartilage.

In their new study, researchers found that improvement in cancer survival was less for patients aged 15-44 in the U.S. with sarcomas. They say this may have been a result of their relative lack of participation in clinical trials.

Following Five-Year Survival

Five-year survival was tracked in more than 38,000 young adults with sarcomas. All were diagnosed between 1975 and 1998.

Sarcomas are one of the most common cancer types in that age group.

The greatest improvement in five-year survival was seen in people with Kaposi scarcoma (KS) patients. Specifically, KS patients aged 30-44 had the biggest survival gains.

The least survival improvement occurred in patients aged 15-44 with sarcomas other than KS.

Survival Improvement, Study Participation Linked

Another trend stood out. It centered on youth participation in clinical trials sponsored by the National Cancer Institute (NCI) from 1997-2002.

The patients with the biggest survival improvement also had the highest participation in NCI-sponsored clinical trials.

Meanwhile, sarcoma patients aged 20-44 had the lowest rate of participation in NCI trials.

Sarcomas that affect soft tissue, such as muscle and cartilage, are more common than KS or bone sarcoma. But researchers found that there were fewer patients in clinical trials for the most common type of sarcoma.

And they found a direct correlation between survival and trial participation, say the researchers, who included Archie Bleyer, MD, of the University of Texas M.D. Anderson Cancer Center.

Few Young Participants

Young adults with soft-tissue sarcomas had a disproportionately low participation rate in clinical trials compared with younger and older patients of all cancers. The numbers were lowest among patients aged 25-45.

That didn’t change much during the study.

Reversing the Trend

Improving participation is possible, but not easy. The researchers note that clinical trial participation by KS patients has gotten better. So has overall cancer trial participation by patients aged 45 and older.

“It will require broad support and cooperation to increase clinical trial availability, access, and participation,” says the study.

Other countries have the same problem, write Bleyer and colleagues. However, minority under-representation doesn’t seem to be a factor in the U.S.

The study is due for publication in the May 1 issue of Cancer.

By Miranda Hitti, reviewed by Michael W. Smith, MD

SOURCES: Bleyer, A. Cancer, May 1, 2005; vol 103. News release, John Wiley & Sons, Inc.