Young adulthood can be a difficult period of development and disruption of age-related milestones can impact psychological well-being. This study examined whether psychological distress differs in young adult (YA) cancer survivors compared to their non-cancer peers and identified factors related to high distress in YA cancer survivors.
Canadian YAs (n = 448) diagnosed between the ages of 15 and 39 were compared with age-, sex-, and education-matched controls (n = 448) randomly sampled from the 2012 Canadian Community Health Survey—Mental Health. The primary measure was the Kessler Psychological Distress Scale (K10). Groups were compared using independent-samples t tests and chi-square tests of independence. Logistic regression was used to examine the factors associated with high (moderate/severe) distress for YA cancer survivors.
YA cancer survivors reported significantly higher distress than their matched peers (24.89 vs. 15.75; p < .0005). In the multivariate model, greater years of education were associated with a decreased likelihood of high distress (adjusted odds ratio (AOR) = 0.84, p = .001). Compared with those working, those in school (AOR = 6.81, p = .003) or not in school/working (AOR = 4.13, p < .0005) reported higher distress. Psychological factors associated with high distress in YA cancer survivors included body image dissatisfaction (AOR = 1.09, p < .0005), poor social support (AOR = 5.19, p = .011), and elevated fears of cancer recurrence (maladaptive: AOR = 6.39, p = .001; clinical: AOR = 12.31, p < .0005).
YA cancer survivors experience significantly greater distress than their non-cancer peers. This distress is associated with modifiable factors such as body image dissatisfaction, social support, and fear of cancer recurrence, illustrating key areas for intervention.
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We gratefully acknowledge the contributions of all the young adults with cancer across Canada who participated in the study.
This study was supported by a patient-oriented research grant from the Newfoundland and Labrador Support for People and Person Oriented Research and Trials (NL SUPPORT) unit. Breanna Lane is funded by a doctoral award from the Translational and Personalized Medicine Initiative/NL SUPPORT Unit. Dr. Sheila Garland is funded by a Beatrice Hunter Cancer Research Institute and Scotiabank New Investigator Award.
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures 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. This study was approved by the Interdisciplinary Committee on Ethics in Human Research (ICEHR–20170502-SC) at Memorial University.
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Lane, B., Fowler, K., Eaton, G. et al. Prevalence and factors associated with high levels of distress in young adult cancer survivors compared to matched peers. Support Care Cancer 29, 2653–2662 (2021). https://doi.org/10.1007/s00520-020-05785-3