Medical Post (2008)

Don’t let youth blind you to a cancer diagnosis

Medical Post (September 2008)

Team Shan, a community based organization in southwestern Ontario, recently completed a breast cancer awareness campaign for young women ages 15-29 years. Public health colleagues, education/media professionals and young adults designed, implemented and evaluated an awareness strategy with the theme “breast cancer…not just a disease of older women.” The project was funded by the Canadian Breast Cancer Foundation-Ontario Chapter. Resources from the project have informed young women and assisted family physicians in their practice.

Highlights from the first Canadian (Cancer in Young Adults in Canada) and North American (Cancer in 15-29 Year Olds) reports on cancer and adolescents/young adults were shared with physicians during the campaign, including these points:

approximately 10,000 cancers are diagnosed in young adults (20-44 years) every year in Canada
cancer is the main cause of early death in young adult women in Canada
almost two thirds of young adult cancers in Canada occur in young women. Breast cancer is the most common
melanoma is the second most common cancer among young adults in Canada
increases in incidence in Canada are most striking for thyroid cancer in young men and women, lymphoma in young women and testicular cancer in young men
ultimately, a larger proportion of cases may be attributable to specific factors or genetic predisposition, but at present, most cancer in this age group (15-29 years) appears to be sporadic and random.

Early detection of cancer is crucial for adolescents and young adults to both increase treatment options and improve outcomes. In a qualitative study published in the November, 2006 issue of the Canadian Family Physician, Dr. Baukje (Bo) Miedema (PhD) and colleagues from Dalhousie attributed delays in detection to “either patients’ or physicians’ inaction.” An editorial articulated the role for family physicians: “Family physicians sometimes failed to consider a diagnosis of cancer because patients were so young. Family physicians should remember that youth is not always a protective factor against cancer.”

A January 4, 2007, McMaster Daily News interview with Dr. Ronald Barr, key editor for the North American report, further emphasized the need for family physicians to respond to symptoms in adolescents and young adults. “Often family physicians aren’t suspicious enough of teenager’s symptoms, interpreting a lump in the neck as an infection or leg pain as an athletic injury or growing pains, which delays an accurate diagnosis.” Family physicians play a critical role in early detection for this population.

Dr. Barr also said that young people’s feelings of invincibility, coupled with a lack of awareness about their cancer risk, are often factors in why the outlook is so poor for this age group. Adolescents and young adults need to be informed in order to self detect symptoms and obtain an assessment.

The Team Shan Community Project is one example of a health promotion awareness strategy for young adults. Doctors need to consider the question, “Could this be cancer?” For more information visit www.teamshan.ca or contact teamshan@gmail.com.

Lorna Larsen
Team Shan Project Lead