Adolescents and young adults are defined in the Australian Cancer Plan (the Plan) as people aged between 15–24 years of age; however, there is variability in the age ranges used in different settings. In Australia, one in eight people (12% of the whole population) are in this age group.[24][25]
Aboriginal and Torres Strait Islander people have a relatively younger age profile than the non-Indigenous population, with 19% of Aboriginal and Torres Strait Islander people aged 15–24 years, and more than half (52%) of all of Aboriginal and Torres Strait Islander people aged under 25 years.[25]
People identifying as belonging to diverse populations may identify across multiple priority population groups. This intersectionality can result in compounding impacts of social, cultural, commercial and environmental determinants of health on cancer experiences and outcomes.
Although cancer in young people is rare, it has a significant impact.[26] In 2023, it is estimated that 1,201 adolescents and young adults will be diagnosed with cancer, and 87 adolescents and young adults will die from cancer.[3] Between 2010 and 2014, the 5-year survival after a cancer diagnosis for adolescents and young adults was 89%, and cancer survivors have a 1.9 times greater risk of developing a second cancer.[26] Despite having a high survival rate, the significant effects of a cancer diagnosis and treatment leaves young cancer survivors living with a range of significant, life-changing late effects related to their cancer experience.[27]
Adolescents and young adults have specific factors that impact their cancer experience, including [27][28][29][30]:
In addition to the direct burden experienced by a diagnosis of cancer in an adolescent or young adult, when a cancer diagnosis occurs in the family, it is not uncommon for a young person to take on caring roles which can result in personal, social, and educational sacrifices. These circumstances increase their level of responsibility and can significantly impact their stage of development, increase psychological distress, and influence their vocational experiences.
The Plan aims to improve the experiences of cancer for adolescents and young adults.
This includes the integration of inclusive survivorship models of care. Such models of care include navigation; specialised education and training to healthcare providers to understand the current and future needs of people in this age group diagnosed with cancer; improving access to optimal cancer care; and improving accessibility, consistency, and comprehensiveness of national data sets.
Year: 2022
Author: Victorian Paediatric Integrated Cancer Service
The Optimal Care Pathway for Adolescents and Young Adults with Cancer was developed with the aim of improving outcomes and experiences of care for young people with cancer. This Optimal Care Pathway (OCP) was designed to complement the existing cancer-specific OCPs. The pathway is to support patients and carers, health systems, health professionals and services to encourage consistent optimal treatment and supportive care that is responsive to the needs of young people and their support networks.
Year: 2019
Author: Cancer Institute NSW, NSW Government
The Adolescent and Young Adults with Cancer: Model of Care for NSW/ACT describes the optimal care and management for adolescent and young adults with cancer in New South Wales and the Australian Capital Territory.
Year: 2023
Author: Canteen
AYA Vision 2033 is a national strategic document that will guide the focus and action on priority issues for Australian AYA cancer care for the next 10 years. It will guide efforts to ensure adolescents and young adults and their families impacted by cancer have equitable access to world-leading diagnosis, treatment, and support from the diagnostic phase through acute care to long-term survivorship outcomes.
Year: 2022
Author: Victorian Paediatric Integrated Cancer Service
The Optimal Care Pathway for Adolescents and Young Adults with Cancer was developed with the aim of improving outcomes and experiences of care for young people with cancer. This Optimal Care Pathway (OCP) was designed to complement the existing cancer-specific OCPs. The pathway is to support patients and carers, health systems, health professionals and services to encourage consistent optimal treatment and supportive care that is responsive to the needs of young people and their support networks.
Year: 2019
Author: Cancer Institute NSW, NSW Government
The Adolescent and Young Adults with Cancer: Model of Care for NSW/ACT describes the optimal care and management for adolescent and young adults with cancer in New South Wales and the Australian Capital Territory.
Year: 2023
Author: Canteen
AYA Vision 2033 is a national strategic document that will guide the focus and action on priority issues for Australian AYA cancer care for the next 10 years. It will guide efforts to ensure adolescents and young adults and their families impacted by cancer have equitable access to world-leading diagnosis, treatment, and support from the diagnostic phase through acute care to long-term survivorship outcomes.
Stakeholders identified the need for greater access to targeted screening programs for adolescents and young people who are at higher risk of developing cancer due to genetic predisposition and other factors.
Stakeholders identified the need for greater access to targeted screening programs for adolescents and young people who are at higher risk of developing cancer due to genetic predisposition and other factors.
Stakeholders observed that adolescents and young adults have distinct challenges associated with a cancer diagnosis, including missing out on school and important social milestones. Limited access to clinical trials for adolescents and young adults, including personalised medicine, is considered to contribute to poorer outcomes.
Inequity exists in survival outcomes for different cancer types, with particular challenges for young people diagnosed with rarer cancers with lower survival rates. Access to multidisciplinary survivorship care was viewed as needed to help young people adapt to cancer recovery.
Concerns were expressed around the safety and efficacy limits to conventional cytotoxic therapies and access to drugs was highlighted as a key challenge for paediatric and young adult oncology.
Stakeholders are concerned by the fertility risks of cancer treatments for adolescents and young adults and highlighted a need for increased research to better understand the relationship between cancer treatments and infertility.
There is also demand for a national data registry of newly diagnosed adolescent and young adult cancers to facilitate monitoring of cancer information and trends to promote improved outcomes.
Adolescents and young adults may not feel directly involved in decision-making regarding their cancer care. Improving the skills of the cancer care workforce to communicate directly with adolescent and young adult cancer patients would support shared decision-making on cancer care and end-of-life choices.
Access to clinical trials needs a cultural shift, as trials and funding tend to only be available in adult or paediatric settings.
The Australian Cancer Plan considers an intersectional and health equity approach for Aboriginal and Torres Strait Islander people. This is more than recognising the multiple backgrounds, experiences, and ways Aboriginal and Torres Strait Islander people identify. This approach addresses the way membership of multiple groups may impact people's health and wellbeing needs and ability to access care.
Implementation of each action should consider the compounding impacts of intersectionality across other priority population groups.