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Health-related quality of life in adolescent and young adult cancer survivors

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Abstract

Purpose

Today, survival rates for adolescent and young adult (AYA) cancer patients exceed 80%. However, cancer and treatment leave many patients suffering from chronic conditions. These late effects may impair their health-related quality of life (HRQoL). We aimed to (1) compare HRQoL of AYA cancer survivors with the Swiss general population and (2) investigate socio-demographic and cancer-related characteristics associated with poor HRQoL.

Methods

AYA cancer survivors (age 16–25 at diagnosis; ≥5 years survival) who had been identified through the Cancer Registry Zurich and Zug, Switzerland, filled out a questionnaire. We assessed HRQoL using the Short-Form 12 (SF-12), producing two scores: Physical Component Summary score (PCS, physical health) and Mental Component Summary score (MCS, mental health). We used multivariable logistic regression analyses to investigate associated characteristics.

Results

We compared 155 survivors with 350 controls. Survivors had significantly lower physical health than controls (mean = 52.5 vs. mean = 54.7, p < 0.001). Male survivors reported better mental health than controls (55.2 vs.53.3, p = 0.078) and females slightly worse (49.8 vs. 51.8, p = 0.285). Poor physical health was strongly associated with having a migration background (OR = 4.63, p = 0.008) and unemployment (OR = 7.66, p = 0.005). Poor mental health was associated with female sex (OR = 2.69, p = 0.057), suffering from late effects (OR = 5.91, p < 0.001) and a migration background (OR = 5.82, p = 0.004).

Conclusions

Results emphasize the need for individualized support services to improve survivors’ HRQoL in vulnerable subgroups. We recommend adapted care for women and migrants, in addition to educational and employment support systems.

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Acknowledgements

We wish to thank all participants for the time and effort invested in answering the questionnaires and the Cancer Registry Zurich and Zug for the provided information and data. This article is based on a revised version of the master thesis “Surviving is not enough: Health-related quality of life in adolescent and young adult cancer survivors” that has been submitted to the Faculty of Humanities and Social Sciences at the University of Lucerne in 2017. The master thesis has been prepared by Erika Harju under the supervision of Gisela Michel and Katharina Roser.

This work was supported by the Swiss National Science Foundation (Ambizione fellowship PZ00P3_121682/1 and PZ00P3–141,722 to GM; grant 100019_153268/1) and Cancer Research Switzerland (Grant No. KFS-3955-08-2016).

Funding

This work was supported by the Swiss National Science Foundation (Ambizione fellowship PZ00P3_121682/1 and PZ00P3–141,722 to GM; grant 100019_153268/1) and Cancer Research Switzerland (Grant No. KFS-3955-08-2016).

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Authors and Affiliations

  1. Department of Health Sciences and Health Policy, University of Lucerne, Frohburgstrasse 3, PO Box 4466, 6002, Lucerne, Switzerland

    Erika Harju, Katharina Roser & Gisela Michel

  2. Cancer Registry Zurich and Zug, Institute of Surgical Pathology, University Hospital Zurich and Epidemiology, Biostatistics and Prevention Institute, University Zurich, Vogelsangstrasse 10, 8091, Zurich, Switzerland

    Silvia Dehler

  3. Departement Gesundheit und Soziales, Abteilung Gesundheit, Bachstrasse 15, 5001, Aarau, Switzerland

    Silvia Dehler

  4. Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, 3012, Bern, Switzerland

    Gisela Michel

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  1. Erika Harju
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  2. Katharina Roser
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  3. Silvia Dehler
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  4. Gisela Michel
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Correspondence to Gisela Michel.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.”

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The authors declare that they have no conflict of interest.

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Informed consent was obtained from all individual participants included in the study.

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Harju, E., Roser, K., Dehler, S. et al. Health-related quality of life in adolescent and young adult cancer survivors. Support Care Cancer 26, 3099–3110 (2018). https://doi.org/10.1007/s00520-018-4151-z

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