What factors determine whether a patient in their 20s with a new oncologic diagnosis is better served by an adult or pediatric center?

It's been 30 years since Dr. Archie Bleyer first pointed out that adolescents and young adults had not enjoyed an increase in survival over a 50-year period that had been seen in pediatric and older adults with cancer.

Since then, every study has shown superior outcomes for young adults treated at pediatric institutions and protocols compared to adult institutions and protocols, most notably in ALL and sarcomas.

Gupta et al., PMID 30912628

AI summary of Adult v Pediatric Outcomes for Young adults with Cancer

Unfortunately, many hospitals and some insurance plans prohibit patients over 18 or 21 from being seen in pediatrics. Often, however, it starts in the ED or primary practice where patients over 18, shunted to the adult side or adult IM, are...