Mental Distress and Cognition among Long-term Survivors of Adolescent and Young Adult Cancer in the United States

Abstract Purpose The majority of childhood, adolescent, and young adult cancer survivors (CAYACS) are at risk of late effects but may not receive long-term follow-up care for these. Here, we investigated (1) self-reported late effects, (2) long-term follow-up care, and (3) factors associated with receiving follow-up care in a population-based sample of Norwegian long-term CAYACS. Methods Survivors were identified by the Cancer Registry of Norway. All > 5-year survivors diagnosed between 1985 and 2009 with childhood cancer (CCS, 0–18 years old, excluding CNS), breast cancer (BC, stages I–III), colorectal cancer (CRC), leukemias (LEUK), non-Hodgkin lymphoma (NHL), or malignant melanoma (MM) at age 19–39 years were mailed a questionnaire (NOR-CAYACS study). Descriptive statistics and logistic regression models were used to analyze occurrence of late effects, long-term follow-up care for these, and associated factors. Results Of 2104 responding survivors, 1889 were eligible for analyses. Of these, 68% were females, with a mean age of 43 years at survey, on average 17 years since diagnosis, and diagnosed with CCS (31%), BC (26%), CRC (8%), NHL (12%), LEUK (7%), and MM (16%). Overall, 61.5% reported the experience of at least one late effect, the most common being concentration/memory problems (28.1%) and fatigue (25.2%). Sixty-nine percent reported not having received long-term follow-up care focusing on late effects. Lower age at survey (p = 0.001), higher education (p = 0.012), and increasing number of late effects (p = < 0.001) were associated with increased likelihood of follow-up care in the multivariate model. Conclusions The majority of survivors reported at least one late effect, but not receiving specific follow-up care for these. This indicates a need for structured models of long-term follow-up to ensure adequate access to care.

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Racial and ethnic trends in illicit drug use and binge drinking among adolescent and young adult offenders in the United States

Journal of Criminal Justice ◽

10.1016/j.jcrimjus.2017.05.009 ◽

2018 ◽

Vol 59 ◽

pp. 71-80 ◽

Cited By ~ 5

Author(s):

Michael G. Vaughn ◽

Christopher P. Salas-Wright ◽

David Cordova ◽

Erik J. Nelson ◽

Lisa Jaegers

Keyword(s):

United States ◽

Young Adult ◽

Drug Use ◽

Binge Drinking ◽

Illicit Drug ◽

Illicit Drug Use ◽

The United States ◽

Adolescent And Young Adult

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Centralizing Temporality in Adolescent and Young Adult Cancer Survivorship

Qualitative Health Research ◽

10.1177/1049732318797087 ◽

2018 ◽

Vol 29 (2) ◽

pp. 173-183 ◽

Cited By ~ 3

Author(s):

Danielle Tindle ◽

Carol Windsor ◽

Patsy Yates

Keyword(s):

Young Adult ◽

Cancer Survivorship ◽

Life Experiences ◽

The United States ◽

Adolescent And Young Adult ◽

Structured Interviews ◽

Use Of Time ◽

Care Models ◽

Young Survivors ◽

Young Adult Cancer

Drawing on Gadamer’s hermeneutic philosophy, this article presents a key outcome of broader research into the phenomenon of adolescent and young adult cancer survivorship. Data were generated through semi-structured interviews with 45 participants from Australia, England, and the United States. The participants received a cancer diagnosis between the ages of 15 and 29 years and were aged 18 to 40 years at the time of interview. The key analytical finding depicts the concept of time as central to the experiences in survivorship. Altered beliefs in temporal progression and biographical chronology affected the organization of time, the structuring and value of life events, and the use of time as a resource. The significance of temporality in young survivors’ experiences warrants its centrality in the design of survivorship care models that reflect a broader understanding of the life experiences of this population.

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A Retrospective Evaluation of Risk of Peripartum Cardiac Dysfunction in Survivors of Childhood, Adolescent and Young Adult Malignancies

Cancers ◽

10.3390/cancers11081046 ◽

2019 ◽

Vol 11 (8) ◽

pp. 1046

Author(s):

Chait-Rubinek ◽

Mariani ◽

Goroncy ◽

Herschtal ◽

Wheeler ◽

...

Keyword(s):

At Risk ◽

Young Adult ◽

Cancer Diagnosis ◽

Cardiac Dysfunction ◽

Adolescent And Young Adult ◽

Cardiac Events ◽

Increased Risk ◽

Cardiac Assessment ◽

Long Term Survivors

Long-term survivors of childhood, adolescent and young adult (AYA) malignancies with past exposure to potentially cardiotoxic treatments are at risk of peripartum cardiac dysfunction. Incidence and risk factors for peripartum cardiac dysfunction and maternal cardiac outcomes in this population were investigated. Eligible long-term survivors were aged <30 years at cancer diagnosis, with ≥1 pregnancy occurring ≥5 years after diagnosis. “Peripartum” cardiac events were defined as occurring within pregnancy or ≤5months after delivery. Cardiac events were classified “symptomatic” or “subclinical”. “Peripartum cardiomyopathy” (PPCM) was defined as symptomatic dysfunction without prior cardiac dysfunction. Of 64 eligible women, 5 (7.8%) had peripartum cardiac events: 3 symptomatic, 2 subclinical. Of 110 live births, 2 (1.8%, 95% CI 0.2–6.4) were defined as PPCM: Significantly greater than the published general population incidence of 1:3000 (p < 0.001), representing a 55-fold (95% CI 6.6–192.0) increased risk. Risk factor analyses were hypothesis-generating, revealing younger age at cancer diagnosis and higher anthracycline dose. Postpartum, cardiac function of 4 women (80%) failed to return to baseline. In conclusion, peripartum cardiac dysfunction is an uncommon but potentially serious complication in long-term survivors of paediatric and AYA malignancies previously treated with cardiotoxic therapies. Peripartum cardiac assessment is strongly recommended for at-risk patients.

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