Patterns and Predictors of Healthcare Use among Adolescent and Young Adult Cancer Survivors versus a Community Comparison Group
by
, , , ,
Ursula M. Sansom-Daly
1,2,3,*
,
Claire E. Wakefield
1,2,
Christina Signorelli
1,2,
Mark W. Donoghoe
1,2,4,
Antoinette Anazodo
1,2,3,
Susan M. Sawyer
5,6,7,
Michael Osborn
8,
Rosalie Viney
9,
Nicholas Daniell
2,
Kate Faasse
10 and
Richard J. Cohn
1,2 1
School of Women’s and Children’s Health, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia
2
Kids Cancer Centre, Behavioural Sciences Unit, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
3
Sydney Youth Cancer Service, Prince of Wales Hospital, Randwick, NSW 2031, Australia
4
Stats Central, Mark Wainwright Analytical Centre, UNSW Sydney, Kensington, NSW 2052, Australia
5
Department of Paediatrics, The University of Melbourne, Melbourne, VIC 3052, Australia
6
Royal Children’s Hospital Centre for Adolescent Health, Melbourne, VIC 3052, Australia
7
Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia
8
Youth Cancer Service SA/NT, Royal Adelaide Hospital, Adelaide, SA 5000, Australia
9
Centre for Health Economics and Research and Evaluation (CHERE), University of Technology Sydney, Sydney, NSW 2000, Australia
10
School of Psychology, UNSW Sydney, Kensington, NSW 2052, Australia
*
Author to whom correspondence should be addressed.
Cancers 2021, 13(21), 5270; https://doi.org/10.3390/cancers13215270
Submission received: 6 August 2021
/
Revised: 13 October 2021
/
Accepted: 13 October 2021
/
Published: 20 October 2021
(This article belongs to the Special Issue Adolescent and Young Adult Oncology)
Simple Summary
Adolescent and young adult cancer survivors face several significant physical/mental health late effects following cancer treatment. These effects may be minimized through healthcare use tailored to young survivors’ needs. Using a cross-sectional study design, we examined the healthcare use of 93 adolescent/young adult cancer survivors (aged 15–39 years), relative to a comparison group of adolescents and young adults recruited from the local community (n = 183). Our cancer survivor group reported greater use of medical and mental health services, and medications during the past six months relative to the comparison group. Our cancer survivor group also reported less psychological distress, and similar work/study participation relative to the comparison group. Survivors who were female, diagnosed with brain/solid tumors and who had finished treatment more recently reported greater healthcare use. Future research is needed to determine whether the healthcare accessed by adolescent and young adult cancer survivors is appropriate and meets their needs.
Abstract
Healthcare use (HCU) during survivorship can mitigate adolescent and young adult (AYA) cancer survivors’ (aged 15–39 years) risk of medical and psychosocial late effects, but this is understudied. We surveyed 93 Australian AYA post-treatment cancer survivors (Mage = 22.0 years, SD = 3.5; 55.9% female) and a comparison sample of 183 non-matched AYAs (Mage = 19.7, SD = 3.2; 70.5% female) on their HCU, medication use, depression/anxiety, and general functioning. Relative to our comparison AYAs, a higher proportion of our survivor group reported medical HCU (community-delivered: 65.6% versus 47.0%, p = 0.003; hospital-delivered: 31.2% versus 20.3%, p = 0.044) and mental HCU (53.8% vs. 23.5%; p < 0.0001) in the past six months. A higher proportion of our survivors reported taking medications within the past six months than our comparison AYAs (61.3% vs. 42.1%, p = 0.003) and taking more types (p < 0.001). Vitamin/supplement use was most common followed by psychotropic medications. Our survivor group reported lower depression (p = 0.001) and anxiety symptoms (p = 0.003), but similar work/study participation (p = 0.767) to our comparison AYAs. Across groups, psychological distress was associated with higher mental HCU (p = 0.001). Among survivors, those who were female, diagnosed with brain/solid tumors and who had finished treatment more recently reported greater HCU. Future research should establish whether this level of HCU meets AYAs’ survivorship needs.
