1693MO - The high burden of long-term and late health-related problems among adolescent and young adult cancer survivors: Results of the SURVAYA study

Background

Adolescents and young adults (AYAs), aged 18-39 years at primary cancer diagnosis, form a distinct population within the oncology community due to their spectrum of cancers, developmental life challenges, and care needs that differ from children and older adults. While the 5-year survival of AYAs is >80%, long-term and late effects can affect the quantity and quality of their life. We studied patient-reported long-term and late health-related problems among AYA cancer survivors.

Methods

Long-term AYA cancer survivors (5-20 years after primary cancer diagnosis) were identified by the population-based Netherlands Cancer Registry (NCR) and invited to participate in a questionnaire study. Participants reported their sociodemographic characteristics, and the occurrence and time of diagnosis of their long-term and late health-related problems. Clinical data were retrieved from the NCR.

Results

3776 AYA cancer survivors (on average 31.6 years old at diagnosis; 12.4 years post-diagnosis) were included for analyses. Participants reported health-related problems with/of their digestive system (15.5%), vision (15.0%), back (14.6%), hormonal system (14.4%), cardiovascular system (12.6%), respiratory system (12.1%), urinary tract (11.0%), depression (8.6%), hearing (7.4%), osteoarthritis (6.9%), second primary cancer (6.4%), and anemia (5.1%). Of the 14 health-related problems that we examined, 35.1% of the participants reported none, 28.8% one and 36.1% reported two or more long-term and late health-related problems. Factors associated with an increased likelihood of long-term and late health-related problems include female sex, higher age at diagnosis, longer time since diagnosis, cancer of the colon/rectum, female genitalia, or thyroid, and treatment with stem cell therapy.

Conclusions

About two-thirds of the AYA cancer survivors experience at least one long-term or late health-related problem. If future research confirms that these problems are caused by cancer or its treatment, appropriate surveillance strategies to identify those at risk and interventions to mitigate those problems should be implemented preferably in AYA survivorship care programs.

Clinical trial identification

NCT05379387. IRB approval: Netherlands Cancer Institute Institutional Review Board NCI-IRBd18122. Approval date: February 6^th, 2019.

Editorial acknowledgement

Legal entity responsible for the study

Nederlands Kanker Instituut – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam the Netherlands.

Funding

Dr. Olga Husson and Silvie Janssen, MSc are supported by a VIDI grant (198.007) of the Netherlands Organization for Scientific Research. Carla Vlooswijk, MSc is supported by the Dutch Cancer Society (#11788 COMPRAYA study). This research was also supported by an institutional grant of the Dutch Cancer Society and of the Dutch Ministry of Health, Welfare and Sport. Data collection of the SURVAYA study was partly supported by the investment grant (#480-08-009) from the Netherlands Organization for Scientific Research.

Disclosure

All authors have declared no conflicts of interest.