Physical, Psychological, Financial Late Effects and Health Care Use in Survivors of Adolescent and Young Adult Cancer: A Population-Based Study
Abstract
Fiscal Year 2021 (FY21) Peer Reviewed Cancer Research Program (PRCRP) Topic Area: Pediatric, adolescent, and young adult cancers. FY21 PRCRP Military Health Focus Areas: Mission Readiness. Cancer is the most common cause of disease-related death in adolescents and young adults (AYA), defined as 15-39-year-old. In 2020, there were approximately 89,500 new cancer cases and 9,270 cancer-related deaths in this age group in the U.S. With advances in treatment, over 85% of AYA with cancer will be cured of their original cancer. Currently, there are approximately 633,000 AYA cancer survivors alive in the U.S. Unfortunately, the intensive therapies needed to cure these AYA can lead to long-term physical and mental problems (known as late effects) as well as financial hardship. Currently, we know very little about how common these late effects are among survivors of AYA cancer, and thus what impact it has on survivors’ quantity and quality of life among survivors of AYA cancer. With this in mind, our study has three objectives: (1) to identify how common late effects are among survivors of AYA cancer, including physical late effects (such as early death, new cancers, dementia, diabetes, heart failure and heart attack, stroke, solid organ transplant, kidney failure), mental late effects (such as depression, anxiety, substance abuse, suicide, and self-harm) and financial effects; (2) to determine what factors increase or decrease the risk of these late effects (such as age, sex, type of cancer, type of treatment) and to use this information to build risk calculators that healthcare providers and patients can use to predict the risk of an individual survivor; and (3) to measure how much healthcare survivors of AYA cancers use, because evidence has indicated that cancer survivors in this age group have increased use of healthcare such as hospitalization and Emergency Department visits, and it is not clear if regular care from a family doctor or oncologist can decrease that risk. We will do this by taking advantage of databases in Ontario, Canada that can identify all interactions between Ontarians and the healthcare system, including doctor visits, emergency room visits, and hospitalizations. Using these databases, we will be able to identify over 100,000 survivors of AYA cancer and compare them to over 500,000 individuals without cancer. Our study thus aims to improve the care of survivors by more accurately predicting their risk of late effects and by informing strategies to monitor and prevent these late effects based on an individual’s specific risk. In addition, our results will allow patients to anticipate the financial burden on survivors, and for healthcare planners to anticipate at a system level the care that survivors will require. Thus, the overarching challenge that our study aims to meet is the development of strategies to improve ease of care/accessibility and to address survivorship issues, including quality of life, long-term treatment effects, psychological impact of recurrence, neurocognitive deficits, and overall mental health.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Dec 28, 2022
- Source ID
- W81XWH2210811
Entities
People
- Paul Nathan
Organizations
- Hospital for Sick Children
- United States Army