Exploring the Feasibility of Establishing a Retrospective Cohort of Survivors of Adolescent and Young Adult Cancer to Study Long-Term Health Outcomes in an Integrated Managed Care Environment.
Exploring the Feasibility of Establishing a Retrospective Cohort of Survivors of Adolescent and Young Adult Cancer to Study Long-Term Health Outcomes in an Integrated Managed Care Environment.
复制标题
探索建立青少年和年轻成人癌症幸存者回顾性队列的可行性，以研究综合管理护理环境中的长期健康结果。
DOI：
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发表时间：
2013
影响因子：
2
通讯作者：
R. Cooper
中科院分区：
文献类型：
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作者：
C. Chao;V. Chiu;Lisa Mueller;R. Cooper
目的
确定对诊断为青少年或年轻人（AYA）并在Kaiser Permanente Southern加州（KPSC）（一家综合管理式护理组织）登记的癌症幸存者进行长期健康结局生存研究的可行性。
方法
其中包括1990年和2000年在KPSC被诊断为15-39岁的幸存者。还确定了1：5年龄、性别和年龄匹配的非癌症KPSC对照组。癌症诊断日期定义为研究基线。在基线后5年和10年计算幸存者的KPSC保险留存率。采用多变量logistic回归分析与基线后≥5年KPSC保险保留相关的人口统计学和癌症特征。
结果
总共确定了6170名AYA癌症患者：4745名（77%）和4471名（72%）分别在诊断后5年和10年存活。在这些幸存者中，分别有3654人（77%）和2817人（63%）在癌症诊断后5年和10年仍在KPSC投保。诊断时年龄在20-29岁之间的人和4期癌症患者比其他幸存者更不可能保留KPSC保险。对于非癌症对照受试者，KPSC保险留存率较低：基线后5年为66%，10年为51%。年龄较小、女性、白色种族和研究基线日历年较晚的人与KPSC保险保留的可能性较低相关。
结论
这些结果表明，在一个大型的综合管理型医疗机构中，进行生存研究以表征AYA癌症幸存者的长期健康结局的可行性和潜在局限性。
PURPOSE
To determine the feasibility of conducting survivorship research for long-term health outcomes with survivors of cancer diagnosed as an adolescent or young adult (AYA) and enrolled in Kaiser Permanente Southern California (KPSC), an integrated managed care organization.
METHODS
Survivors diagnosed at ages 15-39 during 1990 and 2000 at KPSC were included. A 1:5 age-, gender-, and calendar-year-matched non-cancer KPSC comparison group was also identified. Date of cancer diagnosis was defined as the study baseline. KPSC insurance retention rate was calculated at 5 and 10 years post-baseline among survivors. Multivariable logistic regression was used to examine demographic and cancer characteristics associated with KPSC insurance retention at ≥5 years after baseline.
RESULTS
A total of 6170 AYA cancer patients were identified: 4745 (77%) and 4471 (72%) survived at 5 and 10 years after diagnosis respectively. Of these survivors, 3654 (77%) and 2817 (63%) remained insured at KPSC at 5 and 10 years post-cancer diagnosis respectively. Those aged 20-29 years when diagnosed and those with stage 4 cancer were less likely to retain KPSC insurance than other survivors. For non-cancer comparison subjects, the KPSC insurance retention rate was lower: 66% at 5 years and 51% at 10 years post-baseline. Younger age, female gender, white race, and later calendar years of study baseline were associated with a lower likelihood of KPSC insurance retention.
CONCLUSION
These results demonstrate the feasibility and potential limitations of conducting survivorship research to characterize long-term health outcomes for survivors of AYA cancer in a large, integrated managed care organization.