Survivorship after adolescent and young adult cancer: models of care, disparities, and opportunities

Author:

Berkman Amy M1ORCID,Betts Andrea C2,Beauchemin Melissa3,Parsons Susan K45,Freyer David R6,Roth Michael E7ORCID

Affiliation:

1. Department of Oncology, St Jude Children’s Research Hospital , Memphis, TN, USA

2. Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston, School of Public Health , Dallas, TX, USA

3. School of Nursing, Columbia University Irving Medical Center , New York, NY, USA

4. Department of Medicine and Pediatrics, Tufts University School of Medicine , Boston, MA, USA

5. Institute for Clinical Research and Health Policy Studies and Division of Hematology/Oncology, Tufts Medical Center , Boston, MA, USA

6. Departments of Pediatrics, Medicine, and Population & Public Health Sciences, Keck School of Medicine, University of Southern California , Los Angeles, CA, USA

7. Department of Pediatrics, The University of Texas MD Anderson Cancer Center , Houston, TX, USA

Abstract

Abstract Survivors of adolescent and young adult (AYA; age 15-39 years at diagnosis) cancer are a growing population with the potential to live for many decades after treatment completion. Survivors of AYA cancer are at risk for adverse long-term outcomes including chronic conditions, secondary cancers, impaired fertility, poor psychosocial health and health behaviors, and financial toxicity. Furthermore, survivors of AYA cancer from racially minoritized and low socioeconomic status populations experience disparities in these outcomes, including lower long-term survival. Despite these known risks, most survivors of AYA cancer do not receive routine survivorship follow-up care, and research on delivering high-quality, evidence-based survivorship care to these patients is lacking. The need for survivorship care was initially advanced in 2006 by the Institute of Medicine. In 2019, the Quality of Cancer Survivorship Care Framework (QCSCF) was developed to provide an evidence-based framework to define key components of optimal survivorship care. In this commentary focused on survivors of AYA cancer, we apply the QCSCF framework to describe models of care that can be adapted for their unique needs, multilevel factors limiting equitable access to care, and opportunities to address these factors to improve short- and long-term outcomes in this vulnerable population.

Funder

National Cancer Institute

National Institutes of Health

Archer Foundation

Publisher

Oxford University Press (OUP)

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