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Keiu Paapsi, Margit Mägi, Kaire Innos National Institute for Health Development

Survival outcomes in adolescent hematologic cancer patients in Estonia: does place of treatment matter?. Keiu Paapsi, Margit Mägi, Kaire Innos National Institute for Health Development NAACCR/IACR 2019, Vancouver, BC, Canada. 1. Introduction 2. Methods 3. Results 4. Conclusion.

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Keiu Paapsi, Margit Mägi, Kaire Innos National Institute for Health Development

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  1. Survival outcomes in adolescent hematologic cancer patients in Estonia: does place of treatment matter? Keiu Paapsi, Margit Mägi, Kaire Innos National Institute for Health Development NAACCR/IACR 2019, Vancouver, BC, Canada

  2. 1. Introduction 2. Methods 3. Results 4. Conclusion Population 1.3 million (2011 census) Estonian Cancer registry population based since 1968 3cancer centres 1 adult 1 children 1 combined

  3. 1. Introduction 2. Methods 3. Results 4. Conclusion Cancer incidence among adolescents is increasing Adolescents are a heterogeneous population who can receive care in pediatric or adult cancer settings This population has experienced limited survival gains relative to pediatric and older adult cancer populations In Estonia legally enter adulthood at 18 One of the leading causes of disease-related deaths occurring in this age group Not known whether adult oncologists in Estonia use pediatric protocols

  4. Our aim was tocompare the survival of 15–19 year old cancer patients to those aged 10–14 years and toestimate the proportion of adolescents in Estonia getting treatment at pediatric centers

  5. 1. Introduction 2. Methods 3. Results 4. Conclusion Data: – Estonian Cancer Registry Case definition: – adolescents aged 15–19 years – diagnosed in 2000–2014 – hematologic malignancies (ICCC-3 site group 1 and2) – treatment setting as a proxy to received treatment regimen Survival analysis: – 5-year period survival

  6. 1. Introduction2. Methods 3. Results 4. Conclusion Adolescents 15-19 Mainly diagnosed Lymphomas CNS Leukemias 109 cases diagnosed in 2000–2014: 35 leukemias, 74 lymphomas Age specific incidence Leukemias27.3 per million Lymphomas 56.0 per million

  7. 1. Introduction 2. Methods 3. Results 4. Conclusion

  8. 1. Introduction 2. Methods 3. Results 4. Conclusion

  9. 1. Introduction 2. Methods 3. Results 4. Conclusion 5-year survival for leukemias in 2000–2015 by age groups, in Estonia

  10. 1. Introduction 2. Methods 3. Results 4. Conclusion 5-year survival for lymphomas in 2000–2015 by age groups, in Estonia

  11. 1. Introduction 2. Methods 3. Results 4. Conclusion 58.7%of adolescents were treated at pediatric centres Adolescents treated for cancer in an adult centre were older at diagnosis 5-year survival in 2000–2014 was lower for adolescents compared to children aged 10–14 Differences in 5-year survival were more pronounced for leukemias

  12. 1. Introduction 2. Methods 3. Results 4. Conclusion • Analysis of clinical data is needed to identify used regimens and the proportion of AYAs included in clinical trials. • Control for other possible reasons behind poorer survival: stage at diagnosis, treatment adherence. →Awarenessto increase the proportion of adolescents receiving treatment according to childhood protocols. Guidelines for followup and optimal long-term care. Educationand medical information of these patients on the importance of self-reportingsymptoms.

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