Adolescent and Young Adult (AYA) Cancer Survivorship Practices: An Overview

Abstract

Worldwide, more than 1.2 million adolescents and young adults (AYAs; those aged 15–39 years) are diagnosed with cancer each year. Although considerable variability exists according to cancer site and stage of disease, the 5-year relative survival at the time of diagnosis has been estimated at >80% for all AYA patients with cancer combined. Extensive survivorship research in recent decades has focused on patients diagnosed with cancer as children (<15 years) and older adults (>39 years), yet few studies to date have reported outcomes specifically for patients diagnosed as AYAs. With increasing incidence and improving survival for many tumor types, leading to the majority of AYA patients with cancer becoming long-term survivors, there is a critical need for research efforts to inform the survivorship care of this growing population. This article describes the population of AYA cancer survivors according to their epidemiology and late and long-term effects, the challenges and models of AYA survivorship care, as well as future opportunities for research and healthcare.

Recruiting Adolescent and Young Adult Cancer Survivors for Patient-Reported Outcome Research: Experiences and Sample Characteristics of the SURVAYA Study

“…In past decades, more and more attention has been paid to the unique clinical needs of AYA cancer patients and, in parallel, the development of specialized AYA guidelines and cancer centers internationally [ 7 , 8 , 9 , 10 , 11 ]. The unique needs of AYAs with cancer include dealing with issues such as fertility, social isolation, family functioning, employment, and financial toxicity [ 10 , 11 , 12 ].…”

Short- and long-term impact of cancer on employment and financial outcomes of adolescents and young adults (AYAs): a large population-based case-control registry study in the Netherlands

“…age at diagnosis, tumor types and related treatments, different long-term and late effects, no versus limited versus extensive work experience, and one of the first jobs versus close to retirement). 9,40,41 The study of Teckle and colleagues 32 among young Canadian cancer survivors indicates that AYAs may face lower income than their peers. In our study, personal and household income did not differ between the AYAs and controls, even though differences in employment were observed.…”

“…3 A cancer diagnosis, treatment and subsequent physical and psychosocial issues may interrupt and delay or even impede the achievement of these personal goals both in the short and long-term. [4][5][6][7][8][9] Employment is considered a key aspect of healthy AYA cancer survivorship. It enables AYAs to regain a sense of normalcy (i.e.…”

Prevalence of Sleep Disorders, Risk Factors and Sleep Treatment Needs of Adolescents and Young Adult Childhood Cancer Patients in Follow-Up after Treatment

“…Furthermore, childhood cancer survivors report more sleep impairment than peers [ 15 ]. As childhood cancer survivors have an increased risk of adverse physical and mental health outcomes, such as cardiovascular disease, neurocognitive deficits or fatigue [ 16 , 17 , 18 ], having a sleep disorder on top of this creates a higher risk of health burden.…”

“…Furthermore, an increased level of psychological distress, which accompanies living with childhood cancer and survivorship [ 15 , 16 , 18 ], increases the risk of insomnia, a sleep disorder precipitated and perpetuated by distress and hyperarousal [ 27 , 28 ]. Other risk factors might be: more co-morbid health conditions [ 17 , 18 ], which can increase the risk of impaired sleep and insomnia [ 2 , 3 , 4 , 5 , 17 , 18 ]. Additionally, female sex might be a risk factor [ 6 , 11 ], and differences might also emerge in the developmental age groups of adolescence and young adulthood, such as increased levels of CRSD [ 7 , 8 , 9 ].…”