Current issues in adolescent and young adult cancer survivorship.

BACKGROUND Overall, the survival rate for cancer patients has continued to improve over the past several decades. However, those aged 15 to 29 years have not experienced the same improvements in survival. This review explores some of the challenges faced by adolescent and young adult (AYA) cancer patients and their survivorship needs. METHODS Using the OVID Medline database from 1966 to present, a variety of search terms including "adolescent," "young adult," and "cancer survivorship" were entered. Articles related to those obtained by the search were also collected. Additional data were obtained from the SEER database AYA monograph, the Childhood Cancer Survivorship Study, the Report of the Adolescent and Young Adult Oncology Progress Review Group, and the Long-Term Follow-Up Recommendations of the Children's Oncology Group. RESULTS Cancer patients in this age-group are at increased risk for second malignancies, cardiotoxicity, and reproductive difficulties. Few data exist concerning intellectual and other psychosocial issues for this specific patient population. CONCLUSIONS More research is needed to develop accurate data on treatment and survivorship for AYA patients. A separate cancer discipline focusing on improving outcomes in treatment and survivorship among AYA patients should be developed in major academic cancer centers.