Does age matter? Comparing post-treatment psychosocial outcomes in young adult and older adult cancer survivors with their cancer-free peers
Does age matter? Comparing post-treatment psychosocial outcomes in young adult and older adult cancer survivors with their cancer-free peers
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DOI：
10.1002/pon.4490
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发表时间：
2018-05-01
期刊：
影响因子：
3.6
通讯作者：
Campbell, David J. T.
中科院分区：
文献类型：
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作者：
Lang, Michael J.;Giese-Davis, Janine;Campbell, David J. T.
青少年和年轻的成年癌症幸存者（AYA）是一个独特的亚群，具有高度的痛苦和未满足的需求。到目前为止，研究还没有从癌症生存的痛苦中分离出由于发育阶段造成的痛苦。这项以人群为基础的研究允许AYA癌症幸存者，老年人（OA）癌症幸存者，和他们的癌症免费peer.MethodsWe相结合的加拿大社区健康调查（CCHS，2007-2010年）的4个年度周期之间的直接比较，以获得239316受访者的最终样本。我们将总样本分为AYA（15- 39岁，n=83770）和OA（40+，n=155546）。两个标准化的问题确定癌症幸存者（n=14592）。感兴趣的自我报告的结果包括自我感知的健康和心理健康，和医疗保健专业诊断的情绪和焦虑障碍。我们使用加权逻辑回归模型来检查相关性，包括一个交互作用项来评估年龄对效果的影响。结果在调整混杂因素后，AYA的癌症生存率与两种情绪的较高患病率密切相关。（OR 2.00，95% CI 1.44-2.77）和焦虑（OR 2.20，95% CI 1.70-2.86）障碍。OA幸存者在同一方向的相关性较弱（OR 1.10，95% CI 1.01-1.21和OR 1.15，95% CI 1.02-1.30）。AYA癌症幸存者报告的自我感知心理健康水平高于无癌症的同龄人（OR 1.49，95%CI 1.03-2.14），而OAs与无癌同龄人无显著差异（OR 1.03，95%CI 0.92-1.15）。结论AYA癌症幸存者经历的心理社会困扰的风险显著高于他们的癌症和非癌症患者。自由同伴和OA幸存者
ObjectiveAdolescents and young adult cancer survivors (AYA) are a unique subpopulation with high levels of distress and unmet need. To date, studies have not disentangled distress due to developmental life stage from distress due to cancer survivorship. This population-based study allowed a direct comparison between AYA cancer survivors, older adult (OA) cancer survivors, and their cancer-free peers.MethodsWe combined 4 annual cycles of the Canadian Community Health Survey (CCHS, 2007-2010) to obtain a final sample of 239316 respondents. We dichotomized the total sample into AYA (15-39years, n=83770) and OA (40+, n=155546). Two standardized questions identified cancer survivors (n=14592). The self-reported outcomes of interest included self-perceived health and mental health, and health care professional diagnosed mood and anxiety disorders. We used weighted logistic regression models to examine for associations, including an interaction term to assess for effect modification by age.ResultsAfter adjusting for confounders, cancer survivorship in AYAs was strongly associated with higher prevalence of both mood (OR 2.00, 95% CI 1.44-2.77) and anxiety (OR 2.20, 95% CI 1.70-2.86) disorders as compared to their cancer-free peers. OA survivors had a weaker association in the same direction (OR 1.10, 95% CI 1.01-1.21 and OR 1.15, 95% CI 1.02-1.30, respectively). AYA cancer survivors reported higher levels of poor self-perceived mental health than their cancer-free peers (OR 1.49, 95% CI 1.03-2.14), while there was no significant difference from cancer-free peers for OAs (OR 1.03, 95% CI 0.92-1.15).ConclusionsAYA cancer survivors experience a significantly higher risk of psychosocial distress than both their cancer-free peers and OA survivors.