Adolescents and young adults with cancer in Switzerland: a large retrospective single-centre cohort analysis of key care pathways and outcomes by sex and age.
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STUDY AIMS: Adolescents and young adults with cancer represent a distinct population facing unique challenges. While large registry-based studies exist, they often overlook aspects of local care. This study aimed to describe the demographic and clinical characteristics of adolescent and young adult patients with cancer treated at a Swiss tertiary centre, with particular focus on cancer type, sex, age variations, fertility preservation, palliative care, clinical trial participation and survival outcomes. PATIENTS AND METHODS: A retrospective single-centre study was conducted using electronic medical records of patients aged 15-39 years treated for an initial cancer diagnosis at University Hospital Bern (Inselspital) between 2015 and 2021. Descriptive statistics were used to summarise patient and cancer characteristics, and group differences were assessed using K-sample equality of medians and chi-squared tests. Kaplan-Meier plots evaluated 5-year survival, and logistic regression identified survival predictors. RESULTS: The cohort included 395 patients (67% male), with a median age of 27 years. The most frequent diagnoses were Hodgkin lymphoma (25%) and testicular cancer (24%), followed by non-Hodgkin lymphoma, leukaemia and central nervous system tumours (each 11%). Median time from diagnosis to first treatment was 13 days. Fertility consultations were held in 58% of cases (higher among males: 61% vs 50%). Clinical trial participation was 29%. Five-year survival was 84% overall, but significantly lower in older patients and those with metastatic disease. CONCLUSIONS: This is the first study to report on adolescent and young adult cancer patients at a Swiss tertiary centre. While overall survival was favourable, disparities were observed based on age, diagnosis and disease stage. These findings underscore the need for targeted improvements in palliative care services, fertility counselling and trial inclusion for adolescent and young adult cancer patients.