2845 - Psychosocial Distress of Adolescent and Young Adults with Cancer at Diagnosis: A Case-Matched Retrospective Cohort of 2045 Patients in British Columbia.

Background

Adolescents and young adults (AYA) with cancer represent a unique demographic with distinctive developmental and psychosocial pressures. We sought to understand the baseline psychosocial needs of AYAs compared to case matched older adults at diagnosis using the Canadian Problem Checklist (CPC) and the Psychosocial Screen for Cancer - Revised (PSSCAN-R). The CPC is a tool to identify patient concerns in six domains: emotional, practical, spiritual, social, informational and physical. The PSSCAN-R is a validated tool to assess psychosocial needs and distress.

Methods

All AYA patients who completed the CPC and PSSCAN-R within 6 months of their cancer diagnosis between 2011-2016 in the province of British Columbia, Canada were included in the study. Baseline demographics were collected through retrospective chart review. A 3:1 case match based on gender, primary tumor site and metastatic status was performed with older adults (>40 years old) and AYA (18-40 years old). Statistical analysis was undertaken through Chi squared and Fisher’s exact test.

Results

2045 AYAs were case matched by common AYA tumor sites with 6050 older adults. Top five tumor sites were breast (20.4%), lymphoma (11.5%), gastrointestinal (10.8%), thyroid (10.6%), cervix/endometrium (8.0%). 61.9% were female and 12.1% had metastatic disease at diagnosis. The top 6 concerns for AYAs (% AYA, % older adults) were: fear/worry (56.6, 42.9) understanding of illness (47.6, 41.4), sleep (35.2, 28.9), sadness (34.1, 20.0), finances (33.8, 15.0), school/work (33.7, 10.5), all p < 0.01. AYAs reported higher anxiety at baseline (% AYA, % older adults): subclinical (26.0, 19.9), clinical (26.6, 17.1), p < 0.01.

Conclusions

Significant differences in baseline psychosocial needs for AYAs exist across multiple domains. Specifically, higher emotional, financial, school/work distress and baseline anxiety scores. Tailored support with early focus on these domains would benefit this unique and under-served population.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.