Adolescents and young adults with cancer in Switzerland: a large single-centre analysis of key care pathways and outcomes by sex and age

Background: Adolescents and young adults with cancer (AYA) represent a distinct patient group with unique challenges. Most studies reporting outcomes use registry data, leaving local care aspects underreported. Aim: To understand demographic and clinical characteristics of AYA patients focusing on variations by cancer type, sex, and age, as well as fertility preservation, palliative care, clinical trial participation, and survival outcomes. Methods: A retrospective single centre study examined electronic medical records of AYA patients (age 15 to 39 years) treated for their initial diagnosis of cancer at University Hospital Bern (Inselspital) in the period 2015 -2021. Descriptive statistics summarized patient characteristics, and Kaplan-Meier survival curves and logistic regression were used for survival prediction. Results: The AYA cancer cohort consisted of 395 patients (67% male) with a median age of 27. Testicular cancer and Hodgkin lymphoma were the commonest diagnoses (24% and 25% respectively), followed by non-Hodgkin lymphoma (11%), leukaemia (11%), and central nervous system tumours (11%). The median time from diagnosis to first treatment was 13 days. Clinical trial participation was 29% and 58% attended fertility consultations with higher rates among males (61%) than females (50%). Five-year survival for the entire cohort was 84%; lower in older patients and those with metastatic disease. Conclusion: This study provides the first Swiss dataset on AYA cancer patients at a tertiary centre. While survival rates were high, disparities existed by diagnosis and metastatic status. Further research is needed to enhance survival in specific cancers and improve palliative and fertility care.