Biopsychosocial Factors Associated with Supportive Care Needs in Canadian Adolescent and Young Adult Cancer Survivors

Abstract

Adolescents and young adults (AYAs) represent an overlooked population in cancer survivorship care. Identifying the needs of AYAs can guide the development of tailored programs for this population. We conducted a cross-sectional descriptive analysis to identify biopsychosocial factors associated with AYA post-treatment supportive care needs and unmet needs using data obtained from the Experiences of Cancer Patients in Transitions Study of the Canadian Partnership Against Cancer, in collaboration with cancer agencies in the 10 Canadian provinces. The analysis focused on data from n = 530 AYAs between the ages of 18 and 34 who had undergone treatment within the past 5 years. Respondents reported a median of two moderate to big (MTB) physical needs (out of 9) and one unmet physical need, two MTB emotional needs (out of 6) with two unmet MTB emotional needs, and one (out of 5) practical need reported and one unmet MTB practical need. We found some common associations across supportive care domains. Income (lower) and more complex treatment were associated with high needs and unmet needs across the three domains. Respondents with a family doctor who was “very involved” in their cancer care had a lower number of unmet physical and emotional needs. Identifying those at risk of supportive care needs and developing tailored pathways in which they are proactively connected with tailored and appropriate resources and programs may help to reduce the number of unmet needs and improve cancer survivors’ quality of life.

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

“…Up till now, there is no optimal survivorship care model, and many differences (between and within countries) may exist, leaving much room for improvement and still a lot can be learned from each other (e.g., by benchmarking). Despite the emergence of AYA care programs, there is a limited number of programs with survivorship elements [1, 25,73,77,[134][135][136][137].…”

“…In addition, many AYA survivorship issues are still poorly understood and possibly neglected [16,66,73,118,137,154]. Because both HCPs in hospitals and general practitioners (GPs) only see a limited number of AYAs in their practice, they are often unfamiliar with AYA-specific issues and have limited expertise in AYA specific care [12,46,118,136]. Being unfamiliar with this patient population may lead to the provision of suboptimal follow-up care.…”

The Association between Survivorship Care Plans and Patient-Reported Satisfaction and Confidence with Follow-Up Cancer Care Provided by Primary Care Providers

“…Sex-specific prevalence by cancer types (e.g., prostate cancer, breast cancer) may also account for the sex differences in receiving an SCP. AYA patients were less likely to receive an SCP compared to adults; this is important given that previous research has found that younger patients have higher survivorship needs and less satisfied with the transition [ 31 ].…”

Health Care Transitions Among Adolescents and Young Adults With Cancer

“…Optimal transitional practices should incorporate a core set of priorities that have been articulated by AYA cancer survivors. [60][61][62] These include a desire for flexible and individually tailored transitions with effective communication and continuity of providers during the transition process. 63 Previous qualitative work has highlighted survivors' desire for integration of discussions of financial hardship, fertility services, and psychosocial health into long-term care programs.…”