As childhood cancer survival has increased significantly in recent decades in LICs and LMICs, attention is starting to shift to adolescents and young adults (AYA), 15-29 years of age, with paediatric cancers who are yet to be included in most twinning partnerships and nascent paediatric oncology programmes in these countries. There are over 1 million new cancer diagnoses in AYA patients worldwide, the majority in LMICs. Global data on cancer care delivery in this age group is scarce.
HIC rates of AYA survival do not approach that of younger patients due to scarcity of AYA-specific clinical trials, lack of access to appropriate care (diversion to adult oncology programmes that lack expertise in paediatric cancers) and possible biological differences in tumours. Outcome disparities are not as clearly documented in LMIC, but are beginning to be recognized. Therefore, the Global Health Network’s AYA WG is exploring the current landscape of care of AYA patients in LMICs. In particular, the WG is exploring the AYA experiences in LMICs to determine how best to support them and their medical providers over the entire cancer continuum including end-of-life care or survivorship. In 2021, WG members created and translated (currently in English and Spanish) a transition or transfer of care document to be used when adolescents and young adults change care from a paediatric to an adult provider or institution. We have also surveyed physicians in Central America and Mexico to identify where AYA patients with cancer are treated and the barriers and facilitators to caring for them (Alvarez et. al., Society of International Paediatric Oncology, 2021).
We expect that the AYA WG will continue to bring awareness to this unique and often overlooked group of patients. We have successfully recruited approximately 50 members, majority from Latin America at present. The WG has identified collaboration with adult haematologists/oncologists as a key focus. We plan on developing models of clinical care and research to enhance collaboration between paediatric and adult haematologists/oncologists (e.g. consultation services, joint conferences, registry) for a variety of settings to improve AYA care in LMICs.