Outcomes for children and older adults with cancer have improved greatly over the past three decades, but there’s been little improvement in survival among adolescents and young adults with cancer.

That’s the finding of a Keck School of Medicine of USC report showing how overlooked this “middle-child” group is. But that reality is beginning to change at Keck Medicine of USC and elsewhere.

“Cancer survival data are poorly understood for 15- to 39-year-olds,” said Amie Hwang, PhD, assistant professor of clinical preventive medicine at the Keck School. “That makes it difficult for oncologists to accurately estimate, for example, how long a 29-year-old African-American man diagnosed with melanoma is expected to survive because we don’t have detailed cancer trends for this age group.”

Until now. Hwang and her colleagues at the Los Angeles Cancer Surveillance Program have published “Cancer in Los Angeles County: Survival Among Adolescents and Young Adults 1988-2014.” The report card is the first to break down cancer survival rates for 15- to 39-year-olds, USC researchers said. It breaks the data down to segments on race or ethnicity, sex, age group, socioeconomic status, and cancer stage.

The National Cancer Institute released a cancer trends report for this “AYA” group nearly two decades ago. In addition to being dated, the report did not note how socioeconomic status may have an impact on health outcomes.

The new cancer report from the Keck School encompasses 18 of the most common cancers for 15- to 39-year-olds—about 80% of their diagnosed cancers. It includes data on Asians and Pacific Islanders, blacks, whites, and Latinos.

“Adolescents and young adults go to the doctor less often because they have this superhero mentality, like they’re invincible,” said Dennis Deapen, DPH, senior author of the report and professor of clinical preventive medicine at the Keck School. “Once they do go to a health professional, their cancer diagnosis can be delayed because cancer isn’t the first concern doctors have for this age group. It comes as no surprise that patients diagnosed with late-stage cancer have reduced survival rates.”

Cancer is the leading cause of non-accidental death among 15- to 39-year-olds in the United States, according to the report.

The cancer download

About 87,000 adolescents and young adults are diagnosed with cancer in the US each year, seven times more than the number of children and early teens diagnosed, the report noted. Pediatric oncologists are widespread, but AYA oncology is a budding research and clinical area.

In Los Angeles County, about 2,600 AYAs are diagnosed with cancer each year.

In total, the report includes 71,225 cancer cases diagnosed among 3.7 million AYAs who lived in Los Angeles County between 1988 and 2014.

The overarching message from this report is that 15- to 39-year-olds are hit by preventable cancers, Hwang said.

“Prevent cancer by taking charge of your health,” she said. “Screen for cancer, get the HPV vaccine, check for moles that are new or unusual, eat more fruit and vegetables, and exercise. Don’t forget to stay away from tobacco products and heavy drinking.”