The pattern of cancer among adolescents differs from that among young children, yet the common carcinomas of adulthood are still extremely rare in adolescents. The annual incidence of cancer among people aged 13-19 in Western countries in 140-150 per million, with around 700 new cases a year in Britain. The most common cancers, in order of frequency, are lymphomas, tumours of the central nervous system, acute leukaemias, bone and soft tissue sarcomas, germ cell tumours, malignant melanoma, and thyroid carcinoma. The incidence of Hodgkin's disease and bone sarcoma peaks in adolescence or early adulthood. Although the overall incidence of cancer in this age group is stable, testicular cancer, malignant melanoma, other skin cancer, and thyroid cancer have become more common since the 1970s, while ovarian cancer has become less common. 1

The aetiology of cancer in adolescents is poorly understood. A few cases arise as part of a …