Abstract
AimsAdolescents and young adults aged 15–39 years with cancer face unique medical, practical and psychosocial issues. In the UK, principal treatment centres and programmes have been designed to care for teenage and young adult patients aged 13–24 years in an age-appropriate manner. However, for young adults (YAs) aged 25–39 years with cancer, little access to age-specific support is available. The aim of this study was to examine this possible gap by qualitatively exploring YA care experiences, involving patients as research partners in the analysis to ensure robust results. Materials and methodsWe conducted a phenomenological qualitative study with YAs diagnosed with any cancer type between ages 25 and 39 years old in the last 5 years. Participants took part in interviews or focus groups and data were analysed using inductive thematic analysis. Results were shaped in an iterative process with the initial coders and four YA patients who did not participate in the study to improve the rigor of the results. ResultsSixty-five YAs with a range of tumour types participated. We identified seven themes and 13 subthemes. YAs found navigating the healthcare system difficult and commonly experienced prolonged diagnostic pathways. Participants felt under-informed about clinical details and the long-term implications of side-effects on daily life. YAs found online resources overwhelming but also a source of information and treatment support. Some patients regretted not discussing fertility before cancer treatment or felt uninformed or rushed when making fertility preservation decisions. A lack of age-tailored content or age-specific groups deterred YAs from accessing psychological support and rehabilitation services. ConclusionsYAs with cancer may miss some benefits provided to teenagers and young adults in age-tailored cancer services. Improving services for YAs in adult settings should focus on provision of age-specific information and access to existing relevant support.
Highlights
Adolescents and young adults (AYAs) aged 15e39 years with cancer have been described as a distinct group in oncology
Tumour biology and incident cancer types differ in AYAs compared with other ages, further highlighting the need for tailored care [5,6]
It is recognised that unique medical, practical and psychosocial issues arise in cancer patients across the AYA age range, previous research and age-specific services have focused primarily on teenagers and young adults (TYAs)
Summary
Adolescents and young adults (AYAs) aged 15e39 years with cancer have been described as a distinct group in oncology. Tumour biology and incident cancer types differ in AYAs compared with other ages, further highlighting the need for tailored care [5,6]. This message of distinction has brought international attention and action, critics have suggested that it fails to appreciate the heterogeneity of AYAs and differences in experience depending on context [7,8]. It is recognised that unique medical, practical and psychosocial issues arise in cancer patients across the AYA age range, previous research and age-specific services have focused primarily on TYAs. To understand whether tailored support is needed for YAs treated in an adult setting, we aimed to qualitatively explore the healthcare experiences of YAs with cancer treated in UK hospitals
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