An estimated 85,980 adolescents and young adults (AYAs) between the ages of 15 to 39 will be diagnosed with cancer in the United States in 2023. This accounts for about 4% of all cancer diagnoses.

Cancer incidence rates among AYAs have been rising on average 0.3% each year from 2010 to 2019, according to Cancer Stat Facts: Cancer Among Adolescents and Young Adults (AYAs) (Ages 15–39), NCI’s Surveillance, Epidemiology, and End Results (SEER) Program.

The most common cancers in adolescents and young adults (ages 15–39) are:

• breast cancer
• thyroid cancer
• testicular cancer
• melanoma

Other cancers in adolescents and young adults include brain and other central nervous system tumors, cervical cancer, colorectal cancer, leukemia, lymphoma, and sarcomas (including bone cancer and soft tissue sarcoma).

Most common cancers by age group in adolescents and young adults

The incidence of specific cancer types varies according to age. Some cancers are more common in adolescents, while others are more common in young adults.

• In 15 to 19 year olds: testicular cancer, Hodgkin lymphoma, thyroid cancer and brain and central nervous system tumors are the most common cancer types.
• In 20 to 29 year olds: testicular cancer, thyroid cancer, breast cancer, and melanoma are the most common cancer types.
• In 30 to 39 year olds: breast cancer, thyroid cancer, testicular cancer, and cervical cancer are the most common cancer types.

Most common cancers in adolescents and young adults according to sex

Some types of cancers are more common in males, whereas other cancers are more common in females.

• In males, the most common AYA cancers include testicular cancer, colorectal cancer, non-Hodgkin lymphoma, and thyroid cancer.
• In females, the most common AYA cancers include breast cancer, thyroid cancer, melanoma, and cervical cancer.

Survival rates for cancers in adolescents and young adults

Survival rates are increasing among AYAs with cancer. Overall average death rates have been falling 0.9% each year from 2011 to 2020. While relative survival rates are high, at 86% for AYAs when all cancer types are combined, survival rates are much lower for some types of cancer than for others.

Because cancer in young adults is rare, it is important to find an oncologist who specializes in treating the type of cancer you have. Depending on the type of cancer, young adults may have a better outcome when treated on a pediatric, rather than an adult treatment plan. For example, young adults with acute lymphoblastic leukemia (ALL) have better outcomes when treated with more intense “pediatric” type protocols.

Young adults who have a cancer that typically occurs in children and adolescents, such as brain tumors, leukemia, osteosarcoma, and Ewing sarcoma, may be treated by a pediatric oncologist. These doctors are often affiliated with a hospital that is a member of the Children’s Oncology Group. However, young adults who have cancers that are more common in adults, such as breast cancer or colon cancer, are often treated by a medical oncologist through hospitals that are affiliated with an NCI-Designated Cancer Center or a clinical research network such as the National Clinical Trials Network or NCI Community Oncology Research Program.

Getting a second opinion

When possible, it is important to get a second opinion on your cancer treatment plan. After you get a diagnosis and treatment plan from one oncologist, you may choose to get another doctor’s opinion. Most doctors will support and understand your interest in seeking a second opinion and your insurance company may even require a second opinion on the diagnosis and the treatment plan.

When possible, the second opinion should come from an oncologist who specializes in treating the type of cancer that you have. This doctor will usually be the most knowledgeable about the latest cancer treatments, including those for young adults. Seeing a specialist, and getting your initial treatment plan reviewed, can ensure that all aspects of care and treatment are considered. A second opinion may be especially helpful when the first opinion on the treatment plan comes from a doctor who doesn’t specialize in or treat many young adults with the type of cancer that you have.

The type of treatment you receive is based on factors such as:

• the type of cancer
• how advanced the cancer is, including its stage or grade
• biomarker and genetic test results for some types of cancer
• your age and overall health
• personal preferences

Treating cancer in adolescents and young adults

Common treatments include chemotherapy, immunotherapy, radiation therapy, stem cell transplants, surgery, and targeted therapy.

Your treatment options may include:

• Standard medical care (also called standard of care) is treatment that experts agree is appropriate and accepted for a specific disease, such as cancer.
• Cancer treatment clinical trials, (also called clinical studies), are carefully controlled research studies that test new, potentially better, ways to treat cancer. Clinical trials are conducted in a series of steps, called phases. Each phase aims to answer specific medical questions.

Biomarker testing

Biomarker testing looks for biomarkers. Each person’s cancer has a unique pattern of biomarkers, but they have only been discovered for some cancers. Since some biomarkers affect how certain cancer treatments work, biomarker testing may be used to choose the best treatment for some types of cancer. Biomarker testing is different than genetic testing.

Genetic testing

Genetic testing for inherited cancers looks for specific inherited changes (variants) in a person’s genes. Harmful variants in some genes are known to be associated with an increased risk of developing cancer, in about 5% to 10% of all cancers.

Treatment decisions often come with questions and concerns, especially when considering participation in a clinical trial. We can help. Please contact our free, confidential Cancer Information Service at 1-800-4-CANCER (1-800-422-6237) for information and for help finding clinical trials.

Fertility preservation options

Cancer treatments can affect your fertility. It's important to talk with your doctor about whether or not the cancer treatment being advised may increase the risk of, or cause, infertility.

Meeting with a reproductive endocrinologist can help you learn about fertility preservation options before starting treatment. Research has found that although discussions of fertility preservation between doctors and young adult cancer patients are becoming more common, improvements are still needed.

Organizations such as the Oncofertility Consortium and LIVESTRONG Fertility also provide fertility-related support and advice to young adults and health care professionals.

Cancer can create a sense of isolation from friends and family, who may not understand what you are going through. As a young person, you may feel like you are losing your independence at a time when you were just starting to gain it. Perhaps you just began college, landed a job, or started a family. A desire for normalcy may keep you from sharing your experiences with friends.

Learn about unique ways that you can cope and find support: Emotional Support for Young People with Cancer.

For many young people, the completion of treatment is something to celebrate. However, this time may also bring new challenges. You may worry that cancer will return or struggle to get used to new routines. Some young people enter this new phase feeling stronger, whereas others are more fragile. Most young people say the transition after treatment took longer and was more challenging than they anticipated. While most of the side effects that you had during treatment will go away, long-term side effects, such as fatigue, may take time to go away. Other side effects, called late effects, may not occur until months or even years after treatment.

Although follow-up care is important for all survivors, it is especially important for adolescents and young adults. These check-ups can both reassure you and help to prevent or treat medical and psychological problems. Some young people receive follow-up care at the hospital where they were treated, and others see specialists at late effect or survivorship care clinics. Talk with your health care team to learn what follow-up care you should receive and about possible places to receive this important care.

Important documents to get from your doctor and talk about include:

• Treatment summary, with detailed records about your diagnosis and the type(s) of treatment you received.
• Survivorship care plan or follow-up care plan, which addresses both physical and psychological follow-up care that you should receive after cancer treatment. The plan is based on the type of cancer and treatment you received and may vary from person to person.

You'll want to save both paper and electronic copies of these documents for your medical records.

Cancer survivorship clinics and support groups

A growing number of hospitals have survivorship clinics, including programs that focus on follow-up care for young people who have been treated for cancer. Research is also ongoing through the Childhood Cancer Survivor Study to both increase survival rates and to better understand and minimize late effects.

Clinical trials are also working to improve survivorship care programs. One example is the Interactive Survivorship Program for the Improvement of Healthcare Resources in Adolescent and Young Adult Cancer Survivors, the INSPIRE-AYA Study. This study is working to improve access to survivorship resources and is developing an interactive survivorship program aimed at helping adolescents and young adults access follow-up care guidelines and reduce cancer-related distress.

If the cancer you have cannot be cured, or continues to progress despite treatment, it may be called end-stage cancer or terminal cancer. Being told that treatment isn’t working and that you have end-stage cancer is exceptionally difficult to hear. Learn about issues that young people with end-stage cancer face. Get suggestions that can help you have conversations and make choices about end-of-life care and support: Young People Facing End-of-Life Care Decisions.