JAMA Network JAMA Oncology : Metastatic Recurrence Among Adolescents and Young Adults With Cancer
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Nov 26, 2025 Ann Brunson, a senior statistician specializing in cancer outcomes, and Theresa H. M. Keegan, a cancer epidemiologist focused on young adult survivorship, dive into the urgent issue of metastatic recurrence in adolescents and young adults. They discuss why understanding this demographic is crucial, revealing gaps in research and differing recurrence rates based on cancer types. The conversation uncovers alarming trends, including the rise in cervical cancer recurrence, and emphasizes the need for improved screening and health policy to address disparities in care.
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Growing AYA Survivor Burden
- Adolescents and young adults (15–39) are a growing survivor population with over 2 million in the U.S. and rising cancer incidence.
- Many survive 5+ years but face lifelong risks from curative therapies and a growing burden of metastatic disease.
Novel Population-Based Comparison
- The study filled a gap by measuring metastatic recurrence and comparing survival after recurrence versus metastatic disease at diagnosis.
- No prior population-based studies had provided this direct comparison for AYAs.
Algorithm Built With Clinician Validation
- Ann Brunson described building an algorithm from ICD codes and validating it with clinician review of admissions.
- She performed in-depth reviews and iteratively adjusted codes to ensure clinical plausibility.