Patient-reported symptoms, unmet needs, and psychosocial outcomes among adult survivors of pediatric and AYA cancer.

Abstract

e22510 Background: Cancer survivors report symptoms that, if unaddressed, may result in unmet needs and difficulties in adaptation. We examined symptoms, unmet needs, and psychosocial outcomes in individuals diagnosed with pediatric (Peds) or adolescent young adult (AYA) cancers. Methods: Peds (n = 123) and AYA (n = 47) survivors presenting in an adult survivorship clinic completed patient-reported outcome measures for 13 symptoms, unmet need for intervention, and symptoms of depression and anxiety (HADS) Results: Participants were 56% female, primarily white (88%), single (60%), and college graduates (77%). Leukemia (35%) and Hodgkin Lymphoma (HL 21%) were the most common cancers, with HL more common among AYAs (p < .001). Most had received chemotherapy (95%) or XRT (60%) and 56% received both. A minority had undergone surgery (31%) or BMT (21%), with surgery more common among Peds (p < .05). 78% of participants reported at least 2 symptoms, while only 33% reported at least 2 unmet needs for intervention. Number of symptoms (M = 6.6, SD = 3.6) and unmet needs (M = 2.2, SD = 2.7) did not differ by diagnostic age, or by endorsement of any given symptom or need (all p > .05). Most common symptoms included anxiety/worry (68%), concentration problems (59%), and memory difficulties (56%) while the most common unmet needs included fatigue (32%), concentration problems (24%), and memory difficulties (23%). Elevated symptoms of anxiety (28%) were common, though symptoms of depression (7%) less so, and neither differed by diagnostic age group (p < .05). A minority of those with elevated anxiety (44%) or depressive symptoms (42%) reported an unmet need for intervention for these difficulties. Number of symptoms and unmet needs were associated with anxiety (both r > 0.39) and depression (both r > 0.39; all p < .001). Conclusions: Patient-reported symptoms are common among adult Peds and AYA cancer survivors, while unmet needs are less prevalent. Neither differs by age at diagnosis. Symptoms and unmet needs, however, may reflect anxiety and depressive symptoms for which survivors may be more willing to accept intervention than for emotional difficulties per se, representing an opportunity for intervention to improve outcomes.