Health and socioeconomic outcomes for adolescent and young adult cancer survivors

描述(由申请人提供)：我们的研究针对青春期和青春期(AYA)癌症存活率中一个被严重忽视的研究问题：青春期和青壮年期间的癌症诊断如何影响幸存者的生活质量？由于AYA发生的独特的发展转变，如完成教育、开始职业生涯和获得经济独立，癌症诊断可能会给这个年龄段的人带来特别的负担。在癌症幸存者生活质量概念模型的指导下，我们将使用2009年行为危险因素监测系统(BRFSS)数据来评估癌症幸存者的生活质量，以响应PAR 12-035‘S确定的用于评估癌症预防和控制结果的大型国家数据集。在具体目标1中，我们将评估Aya癌症幸存者(确诊年龄为15-39岁)的生活质量，并与同龄的非癌症患者进行比较。在具体目标2中，我们将调查幸存者 与相同年龄段的非癌症患者相比，Aya癌症患者的并存疾病、不良健康行为以及教育和就业限制的风险更高。由于AYAs独特的发育环境，我们认为这些结果(称为“生存因素”)对生活质量至关重要。在这些分析之后，在具体目标3中，我们将确定生活质量是否与感兴趣的生存因素有关，以提供关于最影响不良生活质量的因素的信息 在阿亚幸存者中。对于所有目标，我们将按确诊年龄(例如15-20岁、21-29岁、30-39岁)、当前年龄(例如18-29岁；30-39岁；40-49岁；50-；65岁)和性别来检查我们的结果，以了解独特的亚组差异。我们将确定少数族裔或族裔的幸存者是否面临生活质量低下的特别风险。我们的研究首次通过与对照组的比较来评估癌症对Aya幸存者生活质量的全国影响。到目前为止，对AYA幸存者的大多数研究仅限于具体的癌症诊断，以及从数量有限的癌症登记或不包括比较组的诊所中提取的样本。在R03研究之后，我们的团队将申请R21拨款，以支持随后的混合方法研究。我们将进行定性访谈，为开展一项调查提供信息，以启动对Aya癌症幸存者生活质量的综合评估，该评估考虑到癌症分期和治疗强度的重要差异。R03是朝着实现我们的长期目标迈出的根本一步，我们的长期目标是创建针对Aya幸存者独特的合并症、健康行为、教育和就业需求的干预措施，以提高他们的生活质量。

DESCRIPTION (provided by applicant): Our study targets a significantly understudied research question in adolescent and young adult (AYA) cancer survivorship: How does a cancer diagnosis during adolescence and young adulthood affect survivors' quality of life? Due to the unique developmental transitions that occur for AYAs, such as completing education, starting careers, and gaining financial independence, a cancer diagnosis may cause particular burden for this age group. Guided by a conceptual model of cancer survivor quality of life, we will use the 2009 Behavioral Risk Factor Surveillance System (BRFSS) data to evaluate quality of life for survivors of AYA cancer in response to this PAR 12-035's identification of large, national datasets for assessing cancer prevention and control outcomes. In Specific Aim 1, we will evaluate the quality of life of survivors of AYA cancer (diagnosed ages 15- 39) compared to similarly-aged individuals without cancer. In Specific Aim 2, we will investigate whether survivors of AYA cancer are at higher risk for comorbid conditions, poor health behavior, and educational and employment limitations compared to similarly-aged individuals without cancer. We identified these outcomes (referred to as "Survivorship Factors") as fundamentally important to quality of life due to the unique developmental circumstances of AYAs. Following these analyses, in Specific Aim 3, we will determine whether quality of life is associated with the Survivorship Factors of interest, to provide information on the factors that most influence poor quality of life among AYA survivors. For all aims, we will examine our outcomes by age at diagnosis (e.g., 15-20, 21-29, 30-39), current age (e.g., 18-29; 30-39; 40-49; 50-64; e65) and sex to capture unique sub-group differences. We will determine whether survivors of minority race or ethnicity are at particular risk for poor quality of life. Our study is the first to estimate the nation-wide impactof cancer on AYA survivor quality of life with a control group comparison. To date, the majority of studies on AYA survivors have been limited to specific cancer diagnoses and to samples drawn from a limited number of cancer registries or clinics that do not include a comparison group. Following this R03 study, our team will apply for an R21 grant to support a subsequent mixed methods study. We will perform qualitative interviews to inform a survey to launch a comprehensive evaluation of AYA cancer survivor quality of life that considers important differences in cancer stage and treatment intensity. This R03 is a fundamental step towards meeting our long-term goal of creating interventions tailored to the unique comorbidity, health behavior, educational and employment needs of AYA survivors to improve their quality of life.