Project Milestones: Young Adult Cancer Survivorship

项目里程碑：年轻人癌症幸存者

• 批准号: 10401074
• 负责人: David R Freyer
• 金额: $ 49.14万
• 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/10401074
• 关键词: Acculturation; Achievement; Address; Adherence; Adolescent; Adolescent and Young Adult; Adult; Affect; Aftercare; Age; Attention; California; Cancer Patient; Cancer Survivor; Cancer Survivorship; Caring; Child; Childhood; County; Development; Diagnosis; Education; Employment; Ethnic Origin; Face; Financial Hardship; Gender; Geographic Locations; Goals; Guidelines; Health; Health Personnel; Health Status; Hispanics; 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; Regression Analysis; Reporting; Research; Risk; Risk Factors; Sample Size; Sampling; Services; Social isolation; Surveillance Program; Surveys; Survivors; Time; Treatment-related toxicity; United States; Vulnerable Populations; age group; cancer diagnosis; cancer therapy; cancer type; childhood cancer survivor; clinical trial enrollment; cohort; comorbidity; comparative; emotional distress; ethnic difference; experience; fertility preservation; financial toxicity; follow-up; health care service utilization; health difference; health disparity; health inequalities; health related quality of life; improved; neoplasm registry; population based; programs; protective factors; psychosocial; racial and ethnic disparities; 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 每年有超过 70,000 名青少年和年轻人（AYA；年龄 15-39 岁）被诊断患有癌症 美国年轻患者数量是其8倍多。 AYA 癌症的幸存者是独一无二的 的生命阶段以及缺乏针对该人群的适当服务（例如，生育力保存、保险 覆盖范围和教育/职业支持）。与儿童癌症的年轻成年幸存者相比，很少有 对 AYA 癌症幸存者进行了系统研究，以了解他们的健康相关情况 结果。在诊断和治疗期间，AYA 面临延迟和有限的适当护理机会， 临床试验入组人数较低，治疗相关毒性和发病率较高，生存率较低。早期后期 AYA 癌症幸存者的治疗研究表明存在巨大的经济、社会和个人负担 与癌症的诊断和治疗有关。然而，长期癌症生存经验 AYA 癌症幸存者的健康状况在很大程度上尚未被探索。成年早期的癌症可能会导致丧失或 延迟实现成年里程碑（例如，全职工作、财务健康、婚姻、拥有 儿童）癌症治疗后。此外，对年轻的西班牙裔癌症幸存者的研究还不够， 尽管有证据表明西班牙裔人在健康相关结果方面存在显着差异。 里程碑项目将通过招募和调查基于人群的群体来解决这些研究空白 （n=2,000，约 42% 西班牙裔）代表最常见的长期（诊断后 3-10 年）幸存者 21-39 岁之间诊断的老年 AYA 中发现的癌症。我们的具体目标是： (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实现 AYA 癌症幸存者与非癌症对照者之间的比较； (2)评估风险和保护因素 长期福祉和健康相关的生活质量（HRQOL）； (3) 评估风险和保护因素 参与癌症相关的后续护理。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中心确定的典型 AYA 癌症病例 县癌症监测计划癌症登记处。自我报告调查将评估里程碑 成年期、幸福感、HRQOL 和癌症相关的后续护理。多变量回归分析将 确定里程碑、HRQOL 和癌症相关后续护理的保护因素和风险因素。比较 分析将确定西班牙裔和非西班牙裔 AYA 幸存者之间以及 AYA 病例之间的差异 和非癌症对照参与者（来自加州健康访谈调查）。结果将通知 制定支持 AYA 癌症幸存者的指南和计划，包括解决和 减少影响西班牙裔的健康差距。