A Developmental Science Approach to Informing Age Subgroups in Adolescent and Young Adult Cancer Research

Abstract

PurposeAdolescent and young adult (AYA; diagnosed ages 15–39) cancer survivors are developmentally heterogenous, and this population consists of at least three distinct theoretically informed subgroups, as follows: adolescents, emerging adults, and young adults. However, there are limited evidence-based recommendations for delineating the validity of these subgroups in cancer-specific research. We sought to inform recommended chronological age ranges for each subgroup based on developmental processes. MethodsThe data were collected using a 2x3 stratified sampling design (on-vs. off-treatment; ages 15–17, 18–25, 26–39) and a cross-sectional survey. AYAs (N = 572) completed three subscales of the Inventory of Dimensions of Emerging Adulthood (identity exploration, experimentation/possibilities, and other-focused), and we used regression tree analyses to identify distinct shifts in mean subscale scores that would indicate unique subgroups. Models included (a) chronological age, (b) chronological age + cancer-related variables, and (c) chronological age + sociodemographic/psychosocial variables as predictors of each developmental measure. ResultsThe recommended age ranges for AYA survivors receiving active treatment were consistent with prior research as follows: adolescents ages 15–17, emerging adults ages 18–24, and young adults ages 25–39. Models for off-treatment survivors suggested four distinct subgroups: adolescents ages 15–17, emerging adults ages 18–23, and ‘younger’ (ages 24–32) and ‘older’ young adults (ages 33–39). No sociodemographic or psychosocial variables meaningfully shifted these recommendations. DiscussionOur results suggest that three developmental subgroups remain appropriate for on-treatment survivors, but a second young adult subgroup (ages 33–39) emerged for off-treatment survivors. Therefore, development disruptions may be more likely to occur or manifest in post-treatment survivorship.