1. ¹Cancer Research UK, Paediatric & Familial Cancer Research Group, Royal Manchester Children's Hospital, Stancliffe, Hospital Road, Manchester M27 4HA, UK
2. ²Central Manchester and Manchester Children's University Hospitals, NHS Trust, Pathology Department, Royal Manchester Children's Hospital, Hospital Road, Manchester M27 4HA, UK
3. ³National Cancer Intelligence Centre, Office for National Statistics, 1 Drummond Gate, London SW1V 2QQ, UK

Correspondence: Professor JM Birch, E-mail: jillian.birch@man.ac.uk

Received 25 July 2002; Revised 18 September 2002; Accepted 18 September 2002.

Abstract

Cancer patients aged 15–24 years have distinct special needs. High quality cancer statistics are required for service planning. Data presented by primary site are inappropriate for this age group. We have developed a morphology-based classification and applied it to national cancer registration data for England 1979–1997. The study included 25 000 cancers and 134 million person–years at risk. Rates for each diagnostic group by age, sex and time period (1979–83, 1984–87, 1988–92, 1993–1997) were calculated. Overall rates in 15–19 and 20–24-year-olds were 144 and 226 per million person–years respectively. Lymphomas showed the highest rates in both age groups. Rates for leukaemias and bone tumours were lower in 20–24 year olds. Higher rates for carcinomas, central nervous system tumours, germ-cell tumours, soft tissue sarcomas and melanoma were seen in the older group. Poisson regression showed incidence increased over the study period by an average of 1.5% per annum (P<0.0001). Significant increases were seen in non-Hodgkins lymphoma (2.3%), astrocytoma (2.3%), germ-cell tumours (2.3%), melanoma (5.1%) and carcinoma of the thyroid (3.5%) and ovary (3.0%). Cancers common in the elderly are uncommon in adolescents and young adults. The incidence of certain cancers in the latter is increasing. Future studies should be directed towards aetiology.