Five Year Survival Rate of Adolescents and Young Adults (AYA) Cancer Patients: A Prospective Fixed Cohort Study in Bangladesh

Abstract

Background:  Survivors of adolescent and young adult cancers (AYA) often live 50 to 60 years beyond their diagnosis. Cancer incidence increased in all AYA age groups during the most recent decades, but there were little clinical and epidemiological data from developing countries. There are 7,20,06,601(44.2%) people in Bangladesh under this AYA age group (15-39 years). This study aimed to determine the five-year survival rate of AYA cancer patients.  Methods: The study was a prospective fixed cohort study. The study period was from 2016 to 2021.  Results: Of the total 593 patients, the male and female ratio was 1:1.01. After a follow-up of 5 years, it was documented that 278(46.88%) patients dropped out from follow-up. Among the remaining patients, 185(31.19%) died, and 130(21.92%) were alive. The alive male was 52(40.00%), the female was 78(60.00%), and the ratio was M: F=1:1.5. Highest survival were in germ cell tumour at 80% followed by gestational trophoblastic tumour 77.77%, lymphoma 73.68%, breast cancer 63.64%, ovarian malignancies 57.14%, testicular cancer 50.00% and skin cancer 50.00%. None had insurance coverage, and 92% were dependent on treatment costs.  Conclusion: Evidence-based guidelines for AYA have not been developed for evidence-based late effects screening and care guidelines for AYA cancer patients. The high death (31.19%) occurrence is dangerously alarming for Bangladesh as youth are the majority of the total population. So methods should be searched to reduce the AYA death occurrences.