Adolescent and Young Adult Victims of Cyber Bullying at Increased Risk of Suicide: Female Youth Especially at Risk

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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Young Adult Cancer Survivorship: Recommendations for Patient Follow-up, Exercise Therapy, and Research

JNCI Cancer Spectrum ◽

10.1093/jncics/pkaa099 ◽

2020 ◽

Author(s):

Scott C Adams ◽

Jennifer Herman ◽

Iliana C Lega ◽

Laura Mitchell ◽

David Hodgson ◽

...

Keyword(s):

Young Adult ◽

Late Effects ◽

Adolescent And Young Adult ◽

Future Research ◽

Evidence Based ◽

Pediatric Cancer Survivors ◽

Increased Risk ◽

Care Guidelines ◽

Young Adult Cancer ◽

Evidence Based Guidelines

Abstract Survivors of adolescent and young adult cancers (AYAs) often live 50 to 60 years beyond their diagnosis. This rapidly growing cohort is at increased risk for cancer- and treatment-related late effects that persist for decades into survivorship. Recognition of similar issues in pediatric cancer survivors has prompted the development of evidence-based guidelines for late effects screening and care. However, corresponding evidence-based guidelines for AYAs have not been developed. We hosted an AYA survivorship symposium for a large group of multidisciplinary AYA stakeholders (approximately 200 were in attendance) at Princess Margaret Cancer Centre (Toronto, ON) to begin addressing this disparity. The following overview briefly summarizes and discusses the symposium’s stakeholder-identified high-priority targets for late effects screening and care, and highlights knowledge gaps to direct future research in the field of AYA survivorship. This overview, while not exhaustive, is intended to stimulate clinicians to consider these high-priority screening and care targets when seeing survivors in clinical settings and, ultimately, support the development of evidence-based ‘late effects’ screening and care guidelines for AYAs.

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Significantly Increased Risk of Grade II-IV Acute Gvhd in Adolescent and Young Adult (AYA) Recipients (ages ≥13 years) Vs Childhood Recipients (ages 2-12 years) with Acute Leukemia Following Matched Unrelated Donor (MUD) Stem Cell Transplantation (SCT): The Children's Oncology Group Experience

Biology of Blood and Marrow Transplantation ◽

10.1016/j.bbmt.2019.12.745 ◽

2020 ◽

Vol 26 (3) ◽

pp. S184

Author(s):

Jeffrey R. Andolina ◽

Lingyun Ji ◽

Jim Wang ◽

David R. Freyer ◽

John E. Levine ◽

...

Keyword(s):

Stem Cell ◽

Young Adult ◽

Acute Gvhd ◽

Adolescent And Young Adult ◽

Unrelated Donor ◽

Oncology Group ◽

Matched Unrelated Donor ◽

Increased Risk ◽

Grade Ii ◽

Group Experience

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Recommendations for Premature Ovarian Insufficiency Surveillance for Female Survivors of Childhood, Adolescent, and Young Adult Cancer: A Report From the International Late Effects of Childhood Cancer Guideline Harmonization Group in Collaboration With the PanCareSurFup Consortium

Journal of Clinical Oncology ◽

10.1200/jco.2015.64.3288 ◽

2016 ◽

Vol 34 (28) ◽

pp. 3440-3450 ◽

Cited By ~ 87

Author(s):

Wendy van Dorp ◽

Renée L. Mulder ◽

Leontien C.M. Kremer ◽

Melissa M. Hudson ◽

Marry M. van den Heuvel-Eibrink ◽

...

Keyword(s):

Young Adult ◽

Late Effects ◽

Alkylating Agents ◽

Adolescent And Young Adult ◽

Premature Ovarian Insufficiency ◽

Ovarian Insufficiency ◽

Female Survivors ◽

Increased Risk ◽

Long Term Follow Up ◽

Young Adult Cancer

Purpose Female survivors of childhood, adolescent, and young adult (CAYA) cancer who were treated with alkylating agents and/or radiation, with potential exposure of the ovaries, have an increased risk of premature ovarian insufficiency (POI). Clinical practice guidelines can facilitate these survivors’ access to optimal treatment of late effects that may improve health and quality of survival; however, surveillance recommendations vary among the existing long-term follow-up guidelines, which impedes the implementation of screening. Patients and Methods The present guideline was developed by using an evidence-based approach and summarizes harmonized POI surveillance recommendations for female survivors of CAYA cancer who were diagnosed at age < 25 years. The recommendations were formulated by an international multidisciplinary panel and graded according to the strength of the evidence and the potential benefit gained from early detection and intervention. The harmonized POI surveillance recommendations were developed by using a transparent process and are intended to facilitate care for survivors of CAYA cancer. Results and Conclusion The harmonized set of POI surveillance recommendations is intended to be scientifically rigorous, to positively influence health outcomes, and to facilitate the care for female survivors of CAYA cancer.

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Disparities in the occurrence of late effects following treatment among adolescent and young adult melanoma survivors.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.9580 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. 9580-9580

Author(s):

Alicia Gingrich ◽

Melanie Goldfarb ◽

Candice Sauder ◽

Qian Li ◽

Theodore Wun ◽

...

Keyword(s):

Health Insurance ◽

Young Adult ◽

Late Effects ◽

Respiratory Illness ◽

Cox Proportional Hazards ◽

Adolescent And Young Adult ◽

Low Ses ◽

Bleeding Events ◽

Increased Risk ◽

Race Ethnicity

9580 Background: Melanoma is the third most common cancer in the adolescent and young adult (AYA) population and the incidence worldwide is increasing. However, no studies have addressed the occurrence of late effect medical conditions following melanoma treatment in these young survivors. Methods: All patients ages 15-39 diagnosed with cutaneous melanoma from the 1996-2012 and surviving ≥ 2 years were obtained from the California Cancer Registry and linked to statewide hospitalization data. The influence of age at diagnosis, sex, race/ethnicity, neighborhood socioeconomic status (SES), and health insurance on the development of late effects by system was evaluated using multivariable Cox proportional hazards regression models. Results: Of 8,524 patients, 35.6% were male, 83.1% non-Hispanic white, 82.1% had private health insurance, 60.3% were considered high SES, and 70.7% had no documented co-morbidities at diagnosis. After controlling for competing factors, males had an increased risk of developing late effects across all systems, including cardiac [HR:2.13, 95%CI 1.87-2.42], neurologic (HR:2.24, CI 1.92-2.63), lymphedema (HR:2.22, CI 1.89-2.62), bleeding events (HR:2.35, CI 2.00-2.77), major infection/sepsis (HR:2.23, CI 1.95-2.56), and second cancers [HR:1.66, CI 1.47-1.89]. In addition, patients with public or no insurance (vs. private) had a greater risk of developing all studied late effects, including lymphedema (HR:2.48, CI 2.04-3.01), respiratory illness (HR:2.21, CI 1.85-2.64) renal dysfunction (HR:2.31, CI 1.90-2.81), and subsequent cancers (HR:1.82, CI 1.54-2.16). AYA patients residing in low SES neighborhoods had a similar increased risk of developing late effects. However, neither age nor race/ethnicity had an impact on the occurrence of late effects. Conclusions: Of AYA melanoma survivors, males, those with public or no health insurance, and those living in low SES neighborhoods had a much greater likelihood of developing of late effects. Strategies to improve surveillance and secondary prevention of these late effects is needed among AYA melanoma survivors, particularly for this demographic.

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Adolescent and young adult vegetarianism: better dietary intakeand weight outcomes but increased risk of disordered eatingbehaviors

Obesity and metabolism ◽

10.14341/2071-8713-5254 ◽

2009 ◽

Vol 6 (3) ◽

pp. 70

Author(s):

Keyword(s):

Young Adult ◽

Adolescent And Young Adult ◽

Increased Risk ◽

Weight Outcomes

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Psychopathology in the adolescent and young adult offspring of a community sample of mothers and fathers with major depression

Psychological Medicine ◽

10.1017/s0033291704003587 ◽

2004 ◽

Vol 35 (3) ◽

pp. 353-365 ◽

Cited By ~ 88

Author(s):

DANIEL N. KLEIN ◽

PETER M. LEWINSOHN ◽

PAUL ROHDE ◽

JOHN R. SEELEY ◽

THOMAS M. OLINO

Keyword(s):

Young Adult ◽

Economic Status ◽

Community Sample ◽

Adolescent And Young Adult ◽

Adult Offspring ◽

Mothers And Fathers ◽

Diagnostic Interviews ◽

Increased Risk ◽

Depressed Mothers ◽

Depressive Episodes

Background. There is a large literature indicating that the offspring of mothers with Major Depressive Disorder (MDD) are at increased risk for depression. However, much less is known about the effects of paternal MDD on offspring psychopathology.Method. We addressed this issue using a large community sample of parents and their adolescent and young adult offspring (n=775). Parents and offspring were independently assessed with semi-structured diagnostic interviews. Offspring were interviewed three times from mid-adolescence to age 24 years.Results. Maternal MDD was significantly associated with offspring MDD. Paternal MDD was also significantly associated with MDD in offspring, but only among offspring with depressive episodes of moderate or greater severity. These effects persisted after controlling for socio-economic status, family intactness, and non-mood disorders in both parents. Rates of MDD were particularly elevated in offspring of mothers and fathers with early-onset MDD, and offspring of fathers with recurrent MDD. The magnitude of the associations between MDD in parents and offspring was generally in the small-to-medium range.Conclusions. These results confirm previous findings of elevated risk of MDD in the offspring of depressed mothers. In addition, the results suggest that MDD in fathers is associated with increased risk of depression in offspring, but that it is limited to MDD episodes in offspring of moderate or greater severity.

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Is the Adolescent and Young Adult Cancer Survivor at Risk for Late Effects? It Depends on Where You Look

Journal of Adolescent and Young Adult Oncology ◽

10.1089/jayao.2015.0049 ◽

2016 ◽

Vol 5 (2) ◽

pp. 159-173 ◽

Cited By ~ 11

Author(s):

Erin M. Barthel ◽

Katherine Spencer ◽

Darcy Banco ◽

Elizabeth Kiernan ◽

Susan Parsons

Keyword(s):

At Risk ◽

Young Adult ◽

Cancer Survivor ◽

Late Effects ◽

Adolescent And Young Adult ◽

Young Adult Cancer

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Incidence and Predictors of Mental Health Outcomes Among Survivors of Adolescent and Young Adult Cancer: A Population-Based Study Using the IMPACT Cohort

Journal of Clinical Oncology ◽

10.1200/jco.20.02019 ◽

2021 ◽

pp. JCO.20.02019

Author(s):

Riddhita De ◽

Rinku Sutradhar ◽

Paul Kurdyak ◽

Suriya Aktar ◽

Jason D. Pole ◽

...

Keyword(s):

Mental Health ◽

Young Adult ◽

Health Outcomes ◽

Psychotic Disorder ◽

Population Based ◽

Mental Health Outcomes ◽

Adolescent And Young Adult ◽

Increased Risk ◽

The Impact

PURPOSE Risk and predictors of long-term mental health outcomes in survivors of adolescent and young adult (AYA) cancers are poorly characterized. Mental health is consequently neglected in long-term follow-up. METHODS We identified all AYA in Ontario, Canada age 15-21 years when diagnosed with one of six common cancers between 1992-2012 using a population-based database, and compared them with matched controls. Linkage to provincial healthcare data allowed analysis of rates of outpatient (family physician and psychiatrist) visits for psychiatric indications and time to severe psychiatric events (emergency room visit, hospitalization, and suicide). Demographic-, disease-, and treatment-related predictors of adverse outcomes, including treatment setting (adult v pediatric), were examined. RESULTS Among 2,208 survivors and 10,457 matched controls, 5-year survivors experienced higher rates of outpatient mental health visits than controls (671 visits per 1,000 person-years v 506; adjusted rate ratio [RR] 1.3; 95% CI, 1.1 to 1.5; P = .006). Risk of a severe psychiatric episode was also increased among survivors (adjusted hazard ratio [HR], 1.2; 95% CI, 1.1 to 1.4, P = .008). Risk of a psychotic disorder–associated severe event was doubled in survivors (HR, 2.0, 95% CI, 1.3 to 2.4; P = .007) although absolute risk remained low (15-year cumulative incidence 1.7%; 95% CI, 1.0 to 2.7). In multivariable analysis, survivors treated in adult centers experienced substantially higher outpatient visit rates compared with those treated in pediatric settings (RR 1.8; 95% CI, 1.0 to 3.1; P = .04). CONCLUSION Survivors of AYA cancer are at substantially increased risk of adverse mental health outcomes, with those treated in adult centers at particular risk. Although absolute incidence was low, survivors were at increased risk of psychotic disorder–associated severe events. Long-term mental health surveillance is warranted, as is research into effective interventions during or after cancer treatment.

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