Abstract
Simple SummaryAdolescent and young adult cancer survivors face several significant physical/mental health late effects following cancer treatment. These effects may be minimized through healthcare use tailored to young survivors’ needs. Using a cross-sectional study design, we examined the healthcare use of 93 adolescent/young adult cancer survivors (aged 15–39 years), relative to a comparison group of adolescents and young adults recruited from the local community (n = 183). Our cancer survivor group reported greater use of medical and mental health services, and medications during the past six months relative to the comparison group. Our cancer survivor group also reported less psychological distress, and similar work/study participation relative to the comparison group. Survivors who were female, diagnosed with brain/solid tumors and who had finished treatment more recently reported greater healthcare use. Future research is needed to determine whether the healthcare accessed by adolescent and young adult cancer survivors is appropriate and meets their needs. Healthcare use (HCU) during survivorship can mitigate adolescent and young adult (AYA) cancer survivors’ (aged 15–39 years) risk of medical and psychosocial late effects, but this is understudied. We surveyed 93 Australian AYA post-treatment cancer survivors (Mage = 22.0 years, SD = 3.5; 55.9% female) and a comparison sample of 183 non-matched AYAs (Mage = 19.7, SD = 3.2; 70.5% female) on their HCU, medication use, depression/anxiety, and general functioning. Relative to our comparison AYAs, a higher proportion of our survivor group reported medical HCU (community-delivered: 65.6% versus 47.0%, p = 0.003; hospital-delivered: 31.2% versus 20.3%, p = 0.044) and mental HCU (53.8% vs. 23.5%; p < 0.0001) in the past six months. A higher proportion of our survivors reported taking medications within the past six months than our comparison AYAs (61.3% vs. 42.1%, p = 0.003) and taking more types (p < 0.001). Vitamin/supplement use was most common followed by psychotropic medications. Our survivor group reported lower depression (p = 0.001) and anxiety symptoms (p = 0.003), but similar work/study participation (p = 0.767) to our comparison AYAs. Across groups, psychological distress was associated with higher mental HCU (p = 0.001). Among survivors, those who were female, diagnosed with brain/solid tumors and who had finished treatment more recently reported greater HCU. Future research should establish whether this level of HCU meets AYAs’ survivorship needs.
Highlights
The diagnosis of cancer in an adolescent or young adult (AYA, aged 15–39 years consistent with the broadest global definition) risks fundamentally disrupting their developmental trajectory towards adulthood [1,2,3], compounded by adolescence and young adulthood being the life stage across which mental health disorders are most likely to emerge [4]
This study aimed to examine how a cohort of Australian AYA cancer survivors accessed healthcare to inform how services might best support AYAs to engage with developmentally-appropriate healthcare in survivorship
The cancer diagnoses represented were broadly representative of recent national registry-based data [46], with a slight over-representation of blood cancers relative to typical AYA patient samples, which will to some extent reflect our recruitment from a pool of AYA-aged cancer survivors diagnosed before 15 years old
Summary
The diagnosis of cancer in an adolescent or young adult (AYA, aged 15–39 years consistent with the broadest global definition) risks fundamentally disrupting their developmental trajectory towards adulthood [1,2,3], compounded by adolescence and young adulthood being the life stage across which mental health disorders are most likely to emerge [4]. International estimates suggest that up to 88% can expect to survive their disease and move towards longer-term survivorship and life as an adult [5]. This means that ensuring the physical and mental health and well-being of young cancer survivors is an important priority. AYAs face a range of complex physical and psychosocial late effects that can last decades following completion of cancer treatment. Economic data from Australia show that the loss of productivity and future potential among
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