Project Milestones: Young Adult Cancer Survivorship

项目里程碑：年轻人癌症幸存者

• 批准号: 10543544
• 负责人: David R Freyer
• 金额: $ 46.45万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-04 至 2024-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10543544
• 关键词: Acculturation; Achievement; Address; Adherence; Adolescent; Adolescent and Young Adult; Adolescent and young adult cancer patients; Adult; Affect; Aftercare; Age; Attention; California; Cancer Patient; Cancer Survivor; Cancer Survivorship; Caring; Child; Childhood; County; Development; Diagnosis; Disparity; Education; Employment; Ethnic Origin; Face; Financial Hardship; Gender; Geographic Locations; Goals; Guidelines; Health; Health Personnel; Health Status; Hispanic; Hispanic Populations; Home; Incidence; Inferior; Insurance; Insurance Coverage; Interview; Late Effects; Life; Life Cycle Stages; Link; Longterm Follow-up; Los Angeles; Malignant Childhood Neoplasm; Malignant Neoplasms; Marriage; Medical; Morbidity - disease rate; National Cancer Institute; Newly Diagnosed; Not Hispanic or Latino; Outcome; Outcome Study; Participant; Patient Self-Report; Patients; Personal Satisfaction; Physicians; Policies; Population; Population Heterogeneity; Population Study; Quality of life; Reduce health disparities; Regression Analysis; Reporting; Research; Risk; Risk Assessment; Risk Factors; Sample Size; Sampling; Services; Social isolation; Surveillance Program; Surveys; Survivors; Treatment-related toxicity; United States; Vocation; Vulnerable Populations; age group; cancer diagnosis; cancer therapy; cancer type; childhood cancer survivor; clinical trial enrollment; cohort; comorbidity; comparative; emotional distress; ethnic difference; ethnic disparity; experience; fertility preservation; financial toxicity; follow-up; health care service utilization; health difference; health inequalities; health related quality of life; improved; neoplasm registry; population based; programs; protective factors; psychosocial; racial disparity; recruit; social; survivorship; young adult; young cancer survivor

ABSTRACT Over 70,000 adolescents and young adults (AYAs; age 15-39 years) are diagnosed with cancer every year in the United States, more than 8 times the number of younger patients. Survivors of AYA cancer are unique due to their life stage and lack of appropriate services for this population (e.g., fertility preservation, insurance coverage, and educational/vocational support). In contrast to young adult survivors of childhood cancer, little systematic research has been conducted among survivors of AYA cancer to understand their health-related outcomes. At diagnosis and during treatment, AYAs face delayed and limited access to appropriate care, lower clinical trial enrollment, greater treatment-related toxicity and morbidity, and inferior survival. Early post- treatment studies of AYA cancer survivors indicate numerous financial, social, and personal burdens associated with cancer diagnosis and treatment. However, the long-term cancer survivorship experience among survivors of AYA cancer is largely unexplored. Cancer during young adulthood likely leads to loss or delay in achieving milestones of adulthood (e.g., full-time employment, financial health, marriage, having children) following cancer treatment. Additionally, young adult Hispanic cancer survivors are understudied, despite evidence that Hispanics experience significant differences in health-related outcomes. Project Milestones will address these research gaps by recruiting and surveying a population-based cohort (n=2,000, ~42% Hispanic) representing long-term (3-10 years post-diagnosis) survivors of the most prevalent cancers found in older AYAs diagnosed between ages 21-39. Our specific aims are: (1) To assess risk and protective factors of the achievement of milestones of adulthood and to compare achievement of milestones between survivors of AYA cancer and non-cancer comparators; (2) To assess risk and protective factors of long-term well-being and health related quality of life (HRQOL); and, (3) To assess risk and protective factors of engagement in cancer-related follow-up care. For all outcomes, we will examine age, cancer type, and ethnic differences. Among Hispanic survivors, we will examine cultural factors associated with study outcomes. This population-based study will include prototypical AYA cancer cases ascertained through the Los Angeles County Cancer Surveillance Program Cancer Registry. Self-report surveys will assess milestones of adulthood, well-being, HRQOL, and cancer-related follow-up care. Multivariable regression analyses will identify protective and risk factors for milestones, HRQOL and cancer-related follow-up care. Comparative analyses will identify differences between Hispanic and non-Hispanic AYA survivors and between AYA cases and non-cancer comparator participants (from the California Health Interview Survey). Results will inform the development of guidelines and programs supporting survivors of AYA cancer, including addressing and reducing health disparities affecting those of Hispanic ethnicity.

抽象的 每年被诊断出7万名青少年和年轻人（AYAS； 15-39岁） 美国，是年轻患者人数的8倍以上。 Aya癌的幸存者是独特的 到他们的生活阶段，缺乏适当的服务（例如，保存生育，保险 覆盖范围和教育/职业支持）。与儿童癌的年轻成人幸存者相反，很少 已经在AYA癌症的幸存者中进行了系统的研究，以了解其与健康有关的 结果。在诊断和治疗期间，AYA面临延迟且获得适当护理的机会， 较低的临床试验入学率，与治疗相关的毒性和发病率更高以及生存率下。早期 - AYA癌症幸存者的治疗研究表明了许多财务，社会和个人负担 与癌症诊断和治疗有关。但是，长期的癌症生存经验 在AYA癌症的幸存者中，基本上没有探索。成年期间的癌症可能导致损失或 延迟实现成年里程碑（例如，全职工作，财务健康，婚姻， 儿童）癌症治疗后。此外，年轻的成年西班牙癌症幸存者被研究了 尽管有证据表明西班牙裔在与健康相关的结果上存在显着差异。 项目里程碑将通过招募和调查基于人群的队列来解决这些研究差距 （n = 2,000，〜42％西班牙裔）代表最普遍的长期（诊断后3 - 10年） 在21-39岁之间诊断出的老年AYA中发现的癌症。我们的具体目的是：（1）评估风险和 实现成年里程碑的保护因素并比较里程碑的成就 在AYA癌症的幸存者和非癌症比较者之间； （2）评估风险和保护因素 长期福祉和与健康相关的生活质量（HRQOL）； （3）评估风险和保护因素 参与与癌症有关的随访护理。对于所有结果，我们将检查年龄，癌症类型和 种族差异。在西班牙裔幸存者中，我们将研究与研究相关的文化因素 结果。 这项基于人群的研究将包括通过洛杉矶确定的原型AYA癌症病例 县癌症监测计划癌症注册表。自我报告调查将评估 成年，福祉，HRQOL和与癌症有关的随访护理。多变量回归分析将 确定里程碑，HRQOL和与癌症有关的随访护理的保护性和危险因素。比较 分析将确定西班牙裔和非西班牙裔AYA幸存者以及AYA案件之间的差异 和非癌症比较者参与者（来自加利福尼亚健康访谈调查）。结果将告知 制定支持AYA癌症幸存者的准则和计划，包括解决和 减少影响西班牙种族的健康差异。