Adolescents and Young Adults living with cancer: Patterns of Care and Referral in South Western Sydney Local Health District (SWSLHD) — ASN Events
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Adolescents and Young Adults living with cancer: Patterns of Care and Referral in South Western Sydney Local Health District (SWSLHD) (#351)

Amrita Chandra 1 2 , Angela Berthelsen 1 2 , Penelope Burns 1 2 , Varsha Deshmukh 1 2 , Kirsten Duggan 1 2 , Nasreen Kaadan 1 2 3 , Joyiti Prakash 1 2 , Diana Adams 3
  1. Sydney Local Health District and South Western Sydney Local Health District, Clinical Cancer Registry, Liverpool, NSW, Australia
  2. Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
  3. SWSLHD Cancer Services, Liverpool Cancer Therapy Centre, Sydney, NSW, Australia

Introduction: Adolescents and Young Adults (AYA) with cancer account for 1.7% of all cancer diagnoses in Australia and 1.6% of all cases diagnosed or treated in SWSLHD. They have complex needs and fit neither into traditional paediatric or adult worlds of oncology. Published data demonstrate a disparity in this age group for improvements in survival over time. The study aim was to investigate the population of AYA diagnosed and/or treated with cancer within SWSLHD public facilities, with the purpose of informing service delivery and facilitating quality improvement within our Cancer Service.

Methods: A retrospective cohort of patients aged 15-29 years, diagnosed and/or treated with cancer within SWSLHD public facilities from 2006-2012 were identified from the SWSLHD Clinical Cancer Registry. Significant factors associated with treatment and referral patterns were determined using Chi Square testing. Survival was determined using Kaplan Meier estimates.

Results: 287 newly diagnosed AYA patients were identified. 79% were in the bottom two quintiles for disadvantaged socio-economic status. 28% were born overseas and 15% had a preferred language other than English (LOTE). Most tumours were localised at diagnosis, however patients who had a preferred LOTE presented with more advanced disease compared to English speaking patients. The most common cancer diagnoses were Haematological (24%), Testicular (20%) and Thyroid (17%).  94% received active treatment within SWSLHD public facilities. 63% had Surgery, 28% had Radiotherapy, and 46% received Systemic Therapies. 47% were discussed at Multidisciplinary Team Meeting (MDT). 51% attended Psychosocial Services. 18% attended fertility management. 7% of female patients were pregnant at or within 6 months of diagnosis. One year overall survival was 94%.

Conclusion: Further investigation of local data on patterns of care, survival and supportive care referrals will provide information to guide and plan service delivery and improve quality of care for this special group of patients.

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