566P - Long-term survivorship outcomes of adolescents and young adults (AYA) with cancer of the lower gastrointestinal tract

Background

The incidence of lower gastrointestinal tract (GI) cancers among adolescents and young adults (AYAs) is rising. A cancer diagnosis and treatment(s) can lead to long-term morbidity and disrupt physical, cognitive, and psychosocial development, which can result in a reduced health-related quality of life (HRQOL) in this young population. The aim of this study was to describe the long-term survivorship outcomes of AYA with lower GI cancer.

Methods

The Netherlands Cancer Registry identified AYA cancer survivors (aged 18-39 years at initial cancer diagnosis, 5-20 years past diagnosis). They were invited to participate in a population-based, cross-sectional questionnaire study (SURVAYA). Survivorship issues (EORTC QLQ-SURV111) and HRQOL (EORTC QLQ-C30) were assessed. For this secondary analysis, we used data of all participating AYA colorectal and anal cancer patients.

Results

82 SURVAYA participants were selected (43% colon, 47% rectal and 8% anal cancer; 59% male sex; mean age 34 years at study participation; 11.3 years after diagnosis). Primary treatment consisted of surgery (18%); surgery and chemotherapy (23%); surgery and radiotherapy (10%); radiotherapy and chemotherapy (10%); surgery, radiotherapy and chemotherapy (39%); 35% of patients had a stoma. AYA cancer survivors reported to some extent issues related to body image (41%), sexual intimacy (41%), fertility (49%), social isolation (43%), uncertainty about future (71%), reduced career opportunities (55%), reduced income (41%), and getting a mortgage/insurance (49%). Compared to the normative population, AYA cancer survivors experienced higher levels of fatigue (31.9 vs. 19.4), pain (15.4 vs. 11.4), insomnia (22.4 vs 17.3) and diarrhea (16.2 vs. 5.5); and reported lower physical (89.7 vs. 94.8), role (81.1 vs. 91.7), emotional (77.7 vs. 85.4), cognitive (80.0 vs. 92.0) and social functioning (85.3 vs. 93.6). Overall HRQOL was lower for AYAs compared to the norm (72.1 vs. 75.9; all p<0.05).

Conclusions

A substantial proportion of AYA lower GI cancer survivors reports long-term psychosocial and physical survivorship issues. Access to tailored age-specific healthcare resources is needed to maximize their HRQOL.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Netherlands Cancer Institute.

Funding

Netherlands Organization for Scientific Research.

Disclosure

All authors have declared no conflicts of interest.