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Cancer in Adolescents and Young Adults pp 477–507Cite as

Other Carcinomas

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Part of the book series: Pediatric Oncology ((PEDIATRICO))

Abstract

Carcinomas of importance in AYAs that are not covered in other chapters of this book are carcinomas of the head and neck, lung, and stomach. In American AYAs, the most common anatomical sites of head/neck carcinoma are in the salivary gland, tongue, nasopharynx, gum and nose/nasal cavity/middle ear, in contrast to the predominance of tongue carcinoma in older adults. Much of the difference is likely due to a biologically different type of head/neck carcinoma induced by the human papillomavirus (HPV) and Epstein-Barr virus. Whereas the incidence of head/neck cancer in both older males and females decreased steadily during the 1980s and 1990s due to the decline in smoking, the incidence of head/neck cancer in AYAs continues to increase in AYA females. In the United States, AYA women have had virtually no improvement in the 5-year head/neck-cancer-specific survival rate and AYA males have had less improvement in their survival rate than older adults. The recent increase in oropharyngeal cancer among females escalates the need for HPV immunization. For lung carcinoma, the incidence has declined in older AYAs—a benefit of a national decrease in smoking—but the incidence in younger AYAs has not decreased since 1970. Among the histologic types of lung cancer, carcinoid, neuroendocrine, and broncho-alveolar carcinoma are more prevalent in AYAs than in any older age group. Among lung cancer patients, AYAs also have a greater prevalence of actionable mutations than older patients. AYAs have a better stage-for-stage, 5-year survival rate than older patients. The incidence of gastric carcinoma in the United States is significantly increasing in AYAs in contrast to older persons in whom it has significantly decreased. AYAs are more likely to have advanced stage at diagnosis, signet ring histology, a diffuse type, peritoneal and bone metastases than older patients. Hispanic AYAs with gastric cancer have had no improvement in their 5-year cancer-specific survival since1976, whereas other race/ethnicities and older Hispanics have had steady progress. Treatment of head/neck. lung and gastric carcinoma in AYAs is multimodal, with surgery to the extent feasible, radiotherapy to residual disease at the primary site, chemotherapy for systemic metastases, and as available molecularly-targeted systemic therapy.

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  1. Department of Radiation Medicine, Oregon Health and Sciences University, Portland, OR, USA

    Archie Bleyer

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    Archie Bleyer

  2. McMaster University, Hamilton, Ontario, Canada

    Ronald Barr

  3. RiesSearch LLC, Rockville, Maryland, USA

    Lynn Ries

  4. University College Hospital, London, United Kingdom

    Jeremy Whelan

  5. Pediatric Oncology Unit, National Tumor Institute, Milano, Italy

    Andrea Ferrari

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Bleyer, A. (2017). Other Carcinomas. In: Bleyer, A., Barr, R., Ries, L., Whelan, J., Ferrari, A. (eds) Cancer in Adolescents and Young Adults. Pediatric Oncology. Springer, Cham. https://doi.org/10.1007/978-3-319-33679-4_19

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