Risk of Presenting with Poor-Prognosis Metastatic Cancer in Adolescents and Young Adults: A Population-Based Study
Having metastatic disease at diagnosis poses the great risk of death among AYAs with cancer from all sociodemographic subgroups. This “landscape” study utilized United States Surveillance, Epidemiology, and End Results Program data from 2000–2016 to identify subgroups of AYAs at highest risk for pre...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-10-01
|
| Series: | Cancers |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6694/14/19/4932 |
| _version_ | 1797480066091843584 |
|---|---|
| author | Jessica K. Sheth Bhutada Amie E. Hwang Lihua Liu Kai-Ya Tsai Dennis Deapen David R. Freyer |
| author_facet | Jessica K. Sheth Bhutada Amie E. Hwang Lihua Liu Kai-Ya Tsai Dennis Deapen David R. Freyer |
| author_sort | Jessica K. Sheth Bhutada |
| collection | DOAJ |
| description | Having metastatic disease at diagnosis poses the great risk of death among AYAs with cancer from all sociodemographic subgroups. This “landscape” study utilized United States Surveillance, Epidemiology, and End Results Program data from 2000–2016 to identify subgroups of AYAs at highest risk for presenting with metastases across twelve cancer sites having a poor-prognosis (5-year survival <50% with metastases). Adjusted odds ratios for risk of metastatic disease presentation were compared for AYAs in aggregate and by sociodemographic subgroup (race/ethnicity, sex, socioeconomic status [SES]). In general, AYAs who were male, racial/ethnic minorities, or low SES were at consistently greatest risk of metastases. Strikingly, having metastatic melanoma was independently associated with multiple AYA sociodemographic subgroups, including males (aOR 3.11 [95% CI 2.64–3.66]), non-Hispanic Blacks (4.04 [2.32–7.04]), Asian Pacific Islanders (2.99 [1.75–5.12]), Hispanics (2.37 [1.85–3.04]), and low SES (2.30 [1.89–2.80]). Non-Hispanic Blacks were more likely to present with metastatic cancer in all sites, except for bone, rhabdomyosarcoma, and stomach. Low SES AYAs are more likely to present with metastatic melanoma, bone tumors, soft tissue sarcomas, breast, cervical, lung, and stomach carcinomas. Building on these results, future cancer-specific studies should investigate the connection between sociodemographic risk factors and biological drivers of metastases. This line of research has potential to inform targeted public health and screening efforts to facilitate risk reduction and earlier detection of these deadly diseases. |
| first_indexed | 2024-03-09T21:55:42Z |
| format | Article |
| id | doaj.art-6470f0dcc53e4a85a43f915ea5ebf71a |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T21:55:42Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-6470f0dcc53e4a85a43f915ea5ebf71a2023-11-23T19:59:05ZengMDPI AGCancers2072-66942022-10-011419493210.3390/cancers14194932Risk of Presenting with Poor-Prognosis Metastatic Cancer in Adolescents and Young Adults: A Population-Based StudyJessica K. Sheth Bhutada0Amie E. Hwang1Lihua Liu2Kai-Ya Tsai3Dennis Deapen4David R. Freyer5Cancer and Blood Disease Institute, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USAUSC Norris Comprehensive Cancer Center, Los Angeles, CA 90033, USAUSC Norris Comprehensive Cancer Center, Los Angeles, CA 90033, USALos Angeles Cancer Surveillance Program, Los Angeles, CA 90089, USAUSC Norris Comprehensive Cancer Center, Los Angeles, CA 90033, USACancer and Blood Disease Institute, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USAHaving metastatic disease at diagnosis poses the great risk of death among AYAs with cancer from all sociodemographic subgroups. This “landscape” study utilized United States Surveillance, Epidemiology, and End Results Program data from 2000–2016 to identify subgroups of AYAs at highest risk for presenting with metastases across twelve cancer sites having a poor-prognosis (5-year survival <50% with metastases). Adjusted odds ratios for risk of metastatic disease presentation were compared for AYAs in aggregate and by sociodemographic subgroup (race/ethnicity, sex, socioeconomic status [SES]). In general, AYAs who were male, racial/ethnic minorities, or low SES were at consistently greatest risk of metastases. Strikingly, having metastatic melanoma was independently associated with multiple AYA sociodemographic subgroups, including males (aOR 3.11 [95% CI 2.64–3.66]), non-Hispanic Blacks (4.04 [2.32–7.04]), Asian Pacific Islanders (2.99 [1.75–5.12]), Hispanics (2.37 [1.85–3.04]), and low SES (2.30 [1.89–2.80]). Non-Hispanic Blacks were more likely to present with metastatic cancer in all sites, except for bone, rhabdomyosarcoma, and stomach. Low SES AYAs are more likely to present with metastatic melanoma, bone tumors, soft tissue sarcomas, breast, cervical, lung, and stomach carcinomas. Building on these results, future cancer-specific studies should investigate the connection between sociodemographic risk factors and biological drivers of metastases. This line of research has potential to inform targeted public health and screening efforts to facilitate risk reduction and earlier detection of these deadly diseases.https://www.mdpi.com/2072-6694/14/19/4932Adolescentsyoung adultsincidencerace/ethnicitysexsocioeconomic status |
| spellingShingle | Jessica K. Sheth Bhutada Amie E. Hwang Lihua Liu Kai-Ya Tsai Dennis Deapen David R. Freyer Risk of Presenting with Poor-Prognosis Metastatic Cancer in Adolescents and Young Adults: A Population-Based Study Cancers Adolescents young adults incidence race/ethnicity sex socioeconomic status |
| title | Risk of Presenting with Poor-Prognosis Metastatic Cancer in Adolescents and Young Adults: A Population-Based Study |
| title_full | Risk of Presenting with Poor-Prognosis Metastatic Cancer in Adolescents and Young Adults: A Population-Based Study |
| title_fullStr | Risk of Presenting with Poor-Prognosis Metastatic Cancer in Adolescents and Young Adults: A Population-Based Study |
| title_full_unstemmed | Risk of Presenting with Poor-Prognosis Metastatic Cancer in Adolescents and Young Adults: A Population-Based Study |
| title_short | Risk of Presenting with Poor-Prognosis Metastatic Cancer in Adolescents and Young Adults: A Population-Based Study |
| title_sort | risk of presenting with poor prognosis metastatic cancer in adolescents and young adults a population based study |
| topic | Adolescents young adults incidence race/ethnicity sex socioeconomic status |
| url | https://www.mdpi.com/2072-6694/14/19/4932 |
| work_keys_str_mv | AT jessicakshethbhutada riskofpresentingwithpoorprognosismetastaticcancerinadolescentsandyoungadultsapopulationbasedstudy AT amieehwang riskofpresentingwithpoorprognosismetastaticcancerinadolescentsandyoungadultsapopulationbasedstudy AT lihualiu riskofpresentingwithpoorprognosismetastaticcancerinadolescentsandyoungadultsapopulationbasedstudy AT kaiyatsai riskofpresentingwithpoorprognosismetastaticcancerinadolescentsandyoungadultsapopulationbasedstudy AT dennisdeapen riskofpresentingwithpoorprognosismetastaticcancerinadolescentsandyoungadultsapopulationbasedstudy AT davidrfreyer riskofpresentingwithpoorprognosismetastaticcancerinadolescentsandyoungadultsapopulationbasedstudy |