Patterns of diagnostic imaging and cumulative radiation exposure among long-term young adult cancer survivors.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 6027-6027
Author(s):  
Corinne Daly ◽  
David Urbach ◽  
Therese A. Stukel ◽  
Wayne Deitel ◽  
Paul C. Nathan ◽  
...  
Keyword(s):  
Young Adults ◽  
Young Adult ◽  
Diagnostic Imaging ◽  
Cancer Survivors ◽  
Radiation Exposure ◽  
Imaging Techniques ◽  
Young Adult Cancer Survivors ◽  
Adult Cancer Survivors ◽  
Young Adult Cancer ◽  
Cumulative Radiation Exposure

6027 Background: Young adults surviving a diagnosis of malignancy have a considerable life expectancy, however, little is known about radiation exposure from diagnostic imaging in these patients. This study aims to describe patterns of imaging and radiation exposure in young adult cancer survivors (YAS) and cancer-free controls in Ontario, Canada. Methods: We conducted a population-based retrospective study. Young adults aged 20-44 diagnosed with an invasive malignancy between 1992 and 1999 who lived at least 5 years without recurrent disease were identified in the Ontario Cancer Registry. YAS were matched 1:5 to randomly selected cancer-free controls on calendar year of birth, sex, and geographic location. Radiological procedures were identified through Ontario Health Insurance Plan administrative data. The rate at which individuals underwent diagnostic procedures after surviving 5-years was compared between survivors and controls using Poisson regression. Cumulative radiation exposure due to computed tomography (CT) and standard x-ray were calculated. Results: 20,911 YAS and 104,524 controls had a median of 13.5 years observation time after cancer diagnosis/referent date. The rate of CT scanning after 5 year survival was higher in YAS (rate ratio= 3.59, 95% CI: 3.46 – 3.73) and varied according to malignancy type (Table). Over the course of diagnosis, treatment and surveillance to 10 years, the average YAS was exposed to 33.8 mSv of radiation, 4.4 times the radiation exposure an individual in the general population received. 47% of YAS cumulative dose was attributed to exposure 5 years or more after diagnosis. Conclusions: YAS undergo imaging and are exposed to diagnostic irradiation at a significantly higher rate than controls even after 5 years of recurrence free survival. Alternative imaging techniques not associated with exposure to radiation should be considered for these patients. [Table: see text]

Telehealth coaching for rural-living young adult cancer survivors: A protocol

2019 ◽  
Vol 79 (2) ◽  
pp. 212-224
Author(s):  
Jenson Price ◽  
Jennifer Brunet
Keyword(s):  
Physical Activity ◽  
Young Adults ◽  
Young Adult ◽  
Cancer Survivors ◽  
Rural Areas ◽  
Vegetable Consumption ◽  
Fruit And Vegetable Consumption ◽  
Young Adult Cancer Survivors ◽  
Adult Cancer Survivors ◽  
Young Adult Cancer

Objective: Young adult cancer survivors living in rural areas have reported barriers to participating in health behaviours due to their geographical location and the developmental milestones associated with their age. Existing health behaviour change interventions have generally been delivered face-to-face and have not been tailored to the preferences of young adults living in rural areas, thus not adequately addressing the needs of this population. To address these limitations, this trial aims to examine the feasibility and acceptability of a 12-week telehealth intervention drawing on self-determination theory to promote physical activity participation and fruit and vegetable consumption. Design: The intervention will be tested with young adults who are between the ages of 20 and 39 years, have completed primary treatment, live in an area with fewer than 35,000 inhabitants, are not currently meeting physical activity and fruit and vegetable consumption guidelines, have access to the Internet and audio-visual devices, are ambulatory and are able and willing to provide informed consent. The target sample size is 15. Method: Feasibility data will be collected by recording recommended outcomes throughout the trial. Additional feasibility data as well as acceptability data will be collected using an online questionnaire administered pre- and post-intervention and a semi-structured interview. Results: Results may inform the design and implementation of supportive care services for young adults, and potentially other adults living in rural areas who experience similar barriers to participating in health-promoting behaviours. Conclusion: This trial is one of the first to explore the feasibility and acceptability of a theory-based telehealth behaviour change intervention targeting young adult cancer survivors living in rural areas in order to mitigate the disease burden.

scholarly journals Trekstock RENEW: evaluation of a 12-week exercise referral programme for young adult cancer survivors delivered by a cancer charity

2020 ◽  
Vol 28 (12) ◽  
pp. 5803-5812 ◽  
Author(s):  
G. Pugh ◽  
N. Below ◽  
A. Fisher ◽  
J. Reynolds ◽  
S. Epstone
Keyword(s):  
Young Adults ◽  
Young Adult ◽  
Cancer Survivors ◽  
Physical Function ◽  
Well Being ◽  
Young Adult Cancer Survivors ◽  
Adult Cancer Survivors ◽  
Young Adult Cancer ◽  
Exercise Referral

Abstract Purpose To evaluate the uptake and effect of RENEW, a 12-week exercise referral programme for young adult cancer survivors delivered by Trekstock, a UK-based cancer charity. Methods The RENEW programme provides one-to-one individually tailored support from a level-4 cancer-rehabilitation-qualified gym instructor, free gym membership and access to information resources online. Objective and self-report data on cardiorespiratory function, strength, body composition, fatigue, sleep quality and general health-related quality of life (HRQoL) was collected from participants before the programme (week 0), immediately after (week 12) and 1 month later (week 16). Results Forty-eight young adults (83% female; mean age, 29 years) with a history of cancer took part within the 12-week programme and completed the evaluation measures. Physical activity (PA) levels significantly increased following the programme and remained raised at follow-up. Improvements in physical function were significant: peak expiratory flow (mean change, 30.96, p = 0.003), sit-and-reach test (mean change, 6.55 ± 4.54, p < 0.0001), and 6-mine-walk test (mean change, 0.12 ± 0.04, p < 0.0001). No significant changes in BMI, weight or muscle mass were observed. Improvements in fatigue, sleep and HRQoL were observed across the programme and at follow-up (mean change, weeks 0–16; 8.04 ± 1.49 p < 0.01; 1.05 ± 0.49 p < 0.05; and − 0.9 ± 0.46 p = 0.051, respectively). Changes in self-efficacy to exercise and motivations to exercise were not observed at 12 weeks or at follow-up. Conclusions Results suggest that the RENEW exercise referral programme has a positive impact upon some domains of physical function and well-being among young adult cancer survivors. Implication for cancer survivors Exercise referral programmes delivered by charity organisations are one means by which PA behaviour change support may be widely disseminated to young adult cancer survivors. Health professionals and charitable bodies specialising in the care of young adults with cancer should look to address factors which prevent engagement and uptake of ‘real-world’ PA interventions such as the RENEW programme.

Rates of diagnostic imaging in long-term survivors of young adult malignancies.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 69-69 ◽  
Author(s):  
Corinne Daly ◽  
David Urbach ◽  
Therese A. Stukel ◽  
Wayne Deitel ◽  
Paul C. Nathan ◽  
...  
Keyword(s):  
Young Adult ◽  
Diagnostic Imaging ◽  
Cancer Survivors ◽  
Radiation Exposure ◽  
Ct Scanning ◽  
Population Based ◽  
Plain Radiography ◽  
Young Adult Cancer Survivors ◽  
Adult Cancer Survivors

69 Background: In general, clinical practice guidelines do not recommend the use of diagnostic imaging in long-term surveillance of cancer survivors. Although warranted diagnostic imaging has clinical benefits, the overuse of imaging in cancer survivors may lead to false-positive results, more invasive tests, economic burden and unnecessary radiation exposure. The objective of this study was to determine rates of diagnostic imaging in long-term young adult cancer survivors (YAS) compared to cancer-free controls in Ontario, Canada. Methods: We conducted a population-based retrospective study. Young adults aged 20 to 44 diagnosed with an invasive malignancy between 1992 and 1999 who lived at least 5 years without recurrent disease were identified in the Ontario Cancer Registry. YAS were matched 1:5 to randomly selected cancer-free controls on calendar year of birth, sex, and place of residence. The rate at which YAS received plain radiography, CT, ultrasound and nuclear medicine studies was compared to rates received by controls using Poisson regression. Results: 20,911 survivors and 104,524 controls met our inclusion criteria. YAS received all types of diagnostic imaging at significantly higher rates than controls in the 10 year period after 5-year recurrence-free survival. YAS received CT scanning at a rate 3.6-fold higher than controls (95% confidence interval [CI]: 3.37, 3.62). In contract, the difference in rates of ultrasound between the two groups was more modest (rate ratio [RR] = 1.40, 95% CI: 1.38, 1.43). YAS also received plain radiography (RR =1.66, 95% CI: 1.64, 1.69) and nuclear studies (RR=1.97, 95% CI: 1.89, 2.04) at significantly higher rates than controls, resulting in a 4.6-fold adjusted higher diagnostic radiation dose than controls. Conclusions: Survivors received significantly higher rates of all diagnostic studies after 5-year survival compared to their age-matched cancer-free counterparts. Hazards associated with overuse of imaging such as radiation exposure and heightened anxiety about test results need to be considered. Both patients and providers should be educated about the role of diagnostic imaging in long-term surveillance including the utility of studies without radiation, such as ultrasound.

scholarly journals Lasting effects of cancer and its treatment on employment and finances in adolescent and young adult cancer survivors

Cancer ◽  
2019 ◽  
Vol 125 (11) ◽  
pp. 1908-1917 ◽  
Author(s):  
Tyler G. Ketterl ◽  
Karen L. Syrjala ◽  
Jacqueline Casillas ◽  
Linda A. Jacobs ◽  
Steven C. Palmer ◽  
...  
Keyword(s):  
Young Adult ◽  
Cancer Survivors ◽  
Adolescent And Young Adult ◽  
Young Adult Cancer Survivors ◽  
Adult Cancer Survivors ◽  
Young Adult Cancer

319 Validation of the Insomnia Severity Index Short-Form for Identifying Insomnia Disorder in Young Adult Cancer Survivors

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A128-A128
Author(s):  
Lydia Chevalier ◽  
Alexis Michaud ◽  
Eric Zhou ◽  
Grace Chang ◽  
Christopher Recklitis
Keyword(s):  
Young Adult ◽  
Cancer Survivors ◽  
Sensitivity And Specificity ◽  
Short Form ◽  
A Priori ◽  
Severity Index ◽  
Young Adult Cancer Survivors ◽  
Adult Cancer Survivors ◽  
Young Adult Cancer ◽  
Insomnia Severity

Abstract Introduction Insomnia is a common and impairing late effect experienced by many young adult cancer survivors (YACS). Although routine evaluation of sleep disorders in cancer survivors is recommended, lack of consensus on appropriate screening measures contributes to under-identification and under-treatment of these disorders in YACS. As screening measures are ideally as brief as possible while maintaining validity, we sought to validate the recently published three-item Insomnia Severity Index Short-Form (ISI-SF) in YACS. Methods 250 YACS completed the ISI and the Structured Clinical Interview for the DSM-5 (SCID-5). The ISI-SF was created by summing three ISI items: distress (item #6), interference (item #7), and satisfaction (item #4). In receiver operating characteristic (ROC) analyses, area under the curve (AUC) was calculated to compare discrimination on the ISI-SF to two criteria: the full-scale ISI using a cutoff of ≥8 recently validated in this sample, and the SCID-5 insomnia module. Consistent with previous research, we specified a priori that a cut-off score on the ISI-SF with sensitivity ≥.85 and specificity ≥.75 would be acceptable. Results The ISI-SF had excellent discrimination when compared to the full-scale ISI (AUC = .97) and a cut-off score of ≥4 met criteria with a sensitivity of 97% and specificity of 86%. The ISI-SF had good discrimination when compared to the SCID-5 (AUC = .88), but none of the cut-off scores met a priori criteria for sensitivity and specificity. A cut-off score of ≥4 came closest with a sensitivity of 94% and specificity of 70%. Conclusion Although the ISI-SF did not meet sensitivity and specificity criteria for a stand-alone screening measure when compared to a diagnostic interview, it demonstrated utility as the first step in a two-step screening procedure. Specifically, the high sensitivity of the ≥4 ISI-F cut-off score is well-suited to accurately screening out YACS who do not need insomnia services; as a second screen, the SCID-5 insomnia module could be administered only to those elevated on the ISI-SF in order to identify false positives cases before making referrals for insomnia specialists. Support (if any) National Cancer Institute (1R21CA223832), Swim Across America

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