Abstract A120: Social risks among adolescent and young adult cancer survivors in a US-based integrated delivery system

Abstract

Abstract Purpose: Adolescent and young adult (AYA; diagnosed between the ages of 15-39) cancer survivors are at increased risk of experiencing social risk factors, including financial toxicity, food, housing, and transportation difficulties associated with cancer diagnosis and treatment. Screening for social risks has been shown to be associated with improved health and healthcare outcomes. There is an increased emphasis on implementing social risk screening as part of routine healthcare. However, oncology practices do not routinely assess for and assist patients with social risks, thereby missing a crucial aspect of cancer care. This study aimed to describe the prevalence of social risks among AYA cancer survivors in a United States-based integrated health system. Methods: We analyzed data from 330 AYA members of Kaiser Permanente Northwest (Northwest Oregon and Southwest Washington) who were diagnosed with cancer, either pre- or post-completion of 1 or more social risk screenings between January 1, 2017, to January 30, 2022 (first screening defined as the index date). Four social risk domains (financial hardship, food insecurity, housing instability, and transportation difficulties) were assessed based on patient self-report to indicate the presence or absence of each domain (binary: yes or no). A binary, composite variable was created to assess any social risk (i.e., the presence of any social risk) versus no social risk. Descriptive statistics, including a chi-square test and t-test, were used to compare the prevalence of social risks among AYA cancer survivors overall and by time since cancer diagnosis. Results: Of the 330 patients, the majority were female (n=229, 69%), identified as non-Hispanic white (n=251, 76%), and had an Elixhauser comorbidity index score of 3+ conditions (n=115, 35%). Most AYAs were diagnosed with cancer between the ages of 30-39 (n=181, 59%), and 43% of the AYAs had been diagnosed <1 year (n=141). Overall, the majority of AYA members were diagnosed with cancer prior to their social risk screening (n=301, 91%). We found that nearly one-quarter of patients reported at least one social risk (n=64, 19%), with financial hardship as the most common (14%), followed by food insecurity (9%), housing instability (8%), and transportation difficulties (3%). A greater proportion of patients diagnosed <1 year reported having > 1 social risk (40%), followed by patients diagnosed 1 to <5 years (37%) and patients who had been diagnosed 5+ years (23%). Conclusion: Despite the critical need for strategies to identify and address social risks within the oncology setting, few studies have explored the prevalence and impact of social risks among AYA cancer survivors. Our results suggest that AYA cancer survivors experience the highest burden of social risks proximal to a cancer diagnosis. This work demonstrates the importance of assessing and addressing social risks for AYA cancer survivors. Future studies are needed to evaluate the longitudinal effects of social risks on AYA cancer survivors’ healthcare use and subsequent health outcomes. Citation Format: Carol Y. Ochoa-Dominguez, Kimberly A. Miller, Maria Elena Martinez, David M. Mosen, John F. Dickerson, Ana I. Velázquez Mañana, Matthew P. Banegas. Social risks among adolescent and young adult cancer survivors in a US-based integrated delivery system [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A120.