Adolescent and young adult cancer in Tennessee: An overview of findings

Adolescents and Young Adults (AYAs) ages 15-39 years with cancer have received little attention in the health field, resulting in a lack of progress. The purposes of this study were to use the Tennessee Cancer Registry for all new cancer cases from 2004-2008 to determine the main types of cancer that affect AYAs in Tennessee and understand if there were any cancer types that warranted additional investigation. A total of 8,097 cancer cases were diagnosed in AYAs in Tennessee from 2004-2008. The main types were breast, melanomas, thyroid, lymphomas, and testicular, accounting for over 50% (N=4,269) of cancers in the sample. The incidence of melanoma and thyroid cancer was higher in Tennessee compared to the United States, deserving further examination. In Tennessee, females were significantly more likely to be diagnosed with melanomas (AIR 14.01, 95% CI 12.96-15.06) and thyroid cancers (AIR 13.39, CI 12.37-14.42) compared to males (AIR 8.08, CI 7.28-8.88 and AIR 3.50, CI 2.98-4.03. Regression models were used to further analyze melanoma and thyroid cancers, specifically looking at predictors of late stage diagnosis and treatment types, respectively. Individuals with government insurance were eight times (OR 8.41, CI 3.04-23.27) more likely to be diagnosed with late stage melanoma when compared with private or other types of insurance. Individuals diagnosed with regional or distant stage thyroid cancer compared to localized stage were three times (OR 3.01, CI 1.84-4.94) more likely to have a total thyroidectomy. These data suggest the need for additional cancer prevention and control efforts geared towards AYAs.