Registre National des Cancers de l’Enfant

Etude CADO-BIS CADO-BIS : High Resolution Study on the Diagnostic and Therapeutic Management of Adolescents and Young Adults (AYA, 15-24 years) diagnosed with Cancer
Investigator  Emmanuel Désandes, RNTSE, CHRU Nancy et INSERM UMRS 1153 - team EPICEA
Study period 2015-2017
Objectives To evaluate care pathways and quality of care for young adults (20-24 years) with cancer
Collaborations

Registre National des Tumeurs Solides de l’Enfant (RNTSE, B. Lacour)

Registre National des Hémopathies malignes de l’Enfant (RNHE, J. Clavel)

INSERM UMRS 1153-équipe EPICEA (J. Clavel)

General cancer registries of Calvados (AV Guizard), Doubs et Territoire de Belfort (AS Woronoff), Gironde (R. Salamon), l’Hérault (B. Trétarre), l’Isère (M. Colonna), Loire-Atlantique et Vendée (F. Molinié), la Manche (S. Bara), Lille et sa région (K. Jéhannin-Ligier), Bas-Rhin (M. Velten), Haut-Rhin (E. Marrer), la Somme (O. Ganry), Tarn (P. Grosclaude), Haute Vienne (A. Vergnenegre)

Specialised cancer registries: digestive cancers in Calvados (G. Launoy), haematological malignancies in Calvados (X. Troussard), CNS tumours in Gironde (I. Baldi), haematological malignancies Gironde (A. Monnereau)
Funding Ligue nationale contre le Cancer (Appel d’offres « Adolescents et Cancer ») 2013
Ligue nationale contre le Cancer (Appel d’offres « Adolescents et Cancer ») 2016
Statutory approvals CNIL DR-2014-412
Methods

The study focused on adolescents and young adults (AYA) aged 15 to 24 years, living in mainland France and diagnosed between 01 January 2012 and 31 December 2013, with a cancer (haematological or solid tumour), or a brain tumour whatever its grade.

Data collection was performed by cancer registries participating in the study: socio-demographic data (age, sex, location of residence, date of birth), clinical data (medical history, date of diagnosis, site, extension, histology), treatment data (protocol, clinical trial, treatment scheme), data on adolescent care pathways (at the time of diagnosis, of treatment and post-treatment follow-up) and follow-up data (relapse, vital status and date of last contact).

Results

The study included 993 AYA: 412 adolescents (15-19 years) and 581 young adults (20-24 years).

Management of adolescents (aged 15-19) diagnosed with cancer between 2012 and 2013 has improved compared to previous studies: CADO study (1988-1997, 10% of the French population) and EXECADO study (2006-2007, 41% of the French population).

The results highlight:

- an increase of the participation of paediatric oncologists (in paediatric care units or AYA units) in the treatment process for young people 15-17 years: 52.4% in 2012-2013 versus 51.1% in 2006-2007, and 16.5% in 1988-1997.- an increase of discussion of adolescent cancer at multidisciplinary team meetings (MTM): 85.9% in 2012-2013 versus 53.9% in 2006-2007- an increase of multidisciplinary team meetings involving at least one paediatric oncologist and one adult haemato-oncologist for adolescent patients: 22.9% in 2012-2013 versus 3.1% in 2006-2007.- an increase in enrolment of 15-19 years patients in randomized and non-randomized clinical trials: 39.5% in 2012-2013 versus 27.1% in 2006-2007, and  8.5% in 1988-1997. 

The CADO-BIS study is the first French study to describe care pathways and quality of care of young adults (20-24 years) with cancer. Compared to adolescents care management over the same period (2012-2013), recommendations for the young adults could:

- reduce the time to diagnosis, mainly for soft tissue sarcomas: 49 weeks (21-86) in young adults vs. 15 weeks (5-35) in adolescents (p = 0.02)- promote cancer care in AYA units: 10.0% for young adults vs. 20.6% for adolescents.- improve enrolment of young adults in randomized or non-randomized clinical trials: 16.8% of young adults vs. 39.5% of adolescents- enhance discussion at multidisciplinary team meetings (MTM) involving both paediatric and adult oncologists: 84.5% of which 88.4% in adult MTM, 10.5% mixed MTM, and 1% paediatric MTM.

 Publications  Desandes E, Brugieres L, Molinie F, Defossez G, Delafosse P, Jeahnnin-Ligier K, Velten M, Tretarre B, Amadeo B, Marrer E, Woronoff AS, Ganry O, Monnereau A, Preux PM, Troussard X, Daubisse-Marliac L, Bara S, Guizard AV, Baldi I, Launoy G, Clavel J, Lacour B. Adolescents and Young Adult Oncology Patients in France : heterogeneity in pathway in care. 

Villejuif

INSERM
UMRS1153 Equipe 7
Bâtiment 15/16
16 avenue Paul Vaillant Couturier
94807 Villejuif Cedex

+33 (0)1 45 59 50 37
rnhe@inserm.fr

Nancy

Faculté de Médecine
BP 20199
9 avenue de la Forêt de Haye
54505 Vandoeuvre les Nancy Cedex

+33 (0)3 72 74 63 26
rntse@inserm.fr