Top

Supportive Care in Cancer

Published in:

01-09-2018 | Original Article

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

Authors: Erika Harju, Katharina Roser, Silvia Dehler, Gisela Michel

Published in: Supportive Care in Cancer | Issue 9/2018

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.

Trama A, Botta L, Foschi R, Ferrari A, Stiller C, Desandes E, Maule MM, Merletti F, Gatta G (2016) Survival of European adolescents and young adults diagnosed with cancer in 2000–07: population-based data from EUROCARE-5. Lancet Oncol 17(7):896–906. https://doi.org/10.1016/s1470-2045(16)00162-5 CrossRefPubMed

Arndt V, Feller A, Hauri D, Heusser R, Junker C, Kuehni C, Lorez M, Pfeiffer V, Roy E, Schindler M (2016) Schweizerischer Krebsbericht 2015 - stand und Entwicklungen [Cancer in Switzerland 2015 - situation and development]. Federal Statistical Office FSO, Neuchâtel

Woodward E, Jessop M, Glaser A, Stark D (2011) Late effects in survivors of teenage and young adult cancer: does age matter? Ann Oncol 22(12):2561–2568. https://doi.org/10.1093/annonc/mdr044 CrossRefPubMed

Brown MC, Pearce MS, Bailey S, Skinner R (2016) The long-term psychosocial impact of cancer: the views of young adult survivors of childhood cancer. Eur J Cancer Care 25(3):428–439. https://doi.org/10.1111/ecc.12380 CrossRef

Diller L, Chow EJ, Gurney JG, Hudson MM, Kadin-Lottick NS, Kawashima TI, Leisenring WM, Meacham LR, Mertens AC, Mulrooney DA, Oeffinger KC, Packer RJ, Robison LL, Sklar CA (2009) Chronic disease in the childhood Cancer survivor study cohort: a review of published findings. J Clin Oncol

Oeffinger KC, Mertens AC, Sklar CA, Kawashima T, Hudson MM, Meadows AT, Friedman DL, Marina N, Hobbie W, Kadan-Lottick NS, Schwartz CL, Leisenring W, Robison LL (2006) Chronic health conditions in adult survivors of childhood cancer. N Engl J Med 355(15):1572–1582CrossRefPubMed

Warner EL, Nam GE, Zhang Y, McFadden M, Wright J, Spraker-Perlman H, Kinney AY, Oeffinger KC, Kirchhoff AC (2016) Health behaviors, quality of life, and psychosocial health among survivors of adolescent and young adult cancers. J Cancer Surviv 10(2):280–290. https://doi.org/10.1007/s11764-015-0474-7 CrossRefPubMed

Centers for Disease Control and Prevention. Atlanta G, CDC N (2000) Measuring healthy days. Atlanta, Georgia

Evans DR (1994) Enhancing quality of life in the population at large. Soc Indic Res 33(1/3):47–88CrossRef

10.

Essig S, von der Weid NX, Strippoli MP, Rebholz CE, Michel G, Rueegg CS, Niggli FK, Kuehni CE (2012) Health-related quality of life in long-term survivors of relapsed childhood acute lymphoblastic leukemia. PLoS One 7(5):e38015. https://doi.org/10.1371/journal.pone.0038015 CrossRefPubMedPubMedCentral

11.

Nightingale CL, Quinn GP, Shenkman EA, Curbow BA, Zebrack BJ, Krull KR, Huang IC (2011) Health-related quality of life of young adult survivors of childhood cancer: a review of qualitative studies. J Adolesc Young Adult Oncol 1(3):124–132. https://doi.org/10.1089/jayao.2011.0033 CrossRefPubMedPubMedCentral

12.

Rueegg CS, Gianinazzi ME, Rischewski J, Beck Popovic M, von der Weid NX, Michel G, Kuehni CE (2013) Health-related quality of life in survivors of childhood cancer: the role of chronic health problems. J Cancer Surviv 7(4):511–522. https://doi.org/10.1007/s11764-013-0288-4 CrossRefPubMed

13.

Wengenroth L, Gianinazzi ME, Rueegg CS, Luer S, Bergstraesser E, Kuehni CE, Michel G (2015) Health-related quality of life in young survivors of childhood cancer. Qual Life Res 24:2151–2161. https://doi.org/10.1007/s11136-015-0961-3 CrossRefPubMed

14.

Murnane A, Gough K, Thompson K, Holland L, Conyers R (2015) Adolescents and young adult cancer survivors: exercise habits, quality of life and physical activity preferences. Support Care Cancer 23(2):501–510. https://doi.org/10.1007/s00520-014-2446-2 CrossRefPubMed

15.

Quinn GP, Goncalves V, Sehovic I, Bowman ML, Reed DR (2015) Quality of life in adolescent and young adult cancer patients: a systematic review of the literature. Patient Relat Outcome Meas 6:19–51. https://doi.org/10.2147/PROM.S51658 CrossRefPubMedPubMedCentral

16.

Tai E, Buchanan N, Townsend J, Fairley T, Moore A, Richardson LC (2012) Health status of adolescent and young adult cancer survivors. Cancer 118(19):4884–4891. https://doi.org/10.1002/cncr.27445 CrossRefPubMedPubMedCentral

17.

Bleyer A (2007) Young adult oncology: the patients and their survival challenges. CA Cancer J Clin 57(4):242–255CrossRefPubMed

18.

Docherty SL, Kayle M, Maslow GR, Santacroce SJ (2015) The adolescent and young adult with cancer: a developmental life course perspective. Semin Oncol Nurs 31(3):186–196. https://doi.org/10.1016/j.soncn.2015.05.006 CrossRefPubMed

19.

Kirchhoff AC, Yi J, Wright J, Warner EL, Smith KR (2012) Marriage and divorce among young adult cancer survivors. J Cancer Surviv 6(4):441–450. https://doi.org/10.1007/s11764-012-0238-6 CrossRefPubMed

20.

Lang MJ, Giese-Davis J, Patton SB, Campbell DJT (2017) Does age matter? Comparing post-treatment psychosocial outcomes in young adult and older adult cancer survivors with their cancer-free peers. Psychooncology. https://doi.org/10.1002/pon.4490

21.

Geue K, Sender A, Schmidt R, Richter D, Hinz A, Schulte T, Brahler E, Stobel-Richter Y (2014) Gender-specific quality of life after cancer in young adulthood: a comparison with the general population. Qual Life Res 23(4):1377–1386. https://doi.org/10.1007/s11136-013-0559-6 CrossRefPubMed

22.

Absolom K, Eiser C, Michel G, Walters SJ, Hancock BW, Coleman RE, Snowden JA, Greenfield DM (2009) Follow-up care for cancer survivors: views of the younger adult. Br J Cancer 101(4):561–567. https://doi.org/10.1038/sj.bjc.6605213 CrossRefPubMedPubMedCentral

23.

MC DR, Smith AW, Tao L, Bellizzi KM, Lynch CF, Parsons HM, Kent EE, THM K, for the A. Y. A. Hope Study Collaborative Group (2015) Cancer-related information needs and cancer’s impact on control over life influence health-related quality of life among adolescents and young adults with cancer. Psychooncology 24:–1115. https://doi.org/10.1002/pon.3730

24.

Kuehni CE, Rueegg CS, Michel G, Rebholz CE, Strippoli M-PG, Niggli FK, Egger M, von der Weid NX, for the Swiss Paediatric Oncology Group (2012) Cohort profile: the Swiss childhood cancer survivor study. Int J Epidemiol 41(6):1553–1564. https://doi.org/10.1093/ije/dyr142 CrossRefPubMed

25.

Ware JE, Kosinski M, Keller SD (1995) How to score the SF-12 physical and mental health summary scales. QualityMetric Inc, Lincoln, RI

26.

Flatz A, Casillas A, Stringhini S, Zuercher E, Burnand B, Peytremann-Bridevaux I (2015) Association between education and quality of diabetes care in Switzerland. Int J Gen Med 8:87–92. https://doi.org/10.2147/IJGM.S77139 CrossRefPubMedPubMedCentral

27.

Nübling M, Andersen HH, Mühlbacher A, Schupp J, Wagner GG (2007) Computation of standard values for physical and mental health scale scores using the SOEP version of SF12v2. Schmollers Jahrbuch : journal of applied social science studies. Z Wirtsch Sozialwissen 127(1):171–182

28.

Perneger TV, Hudelson PM, Bovier PA (2004) Health and happiness in young Swiss adults. Qual Life Res 13(1):171–178. https://doi.org/10.1023/b:qure.0000015314.97546.60 CrossRefPubMed

29.

Gandek B, Ware JE, Aaronson NK, Apolone G, Bjorner JB, Brazier JE, Bullinger M, Kaasa S, Leplege A, Prieto L, Sullivan M (1998) Cross-validation of item selection and scoring for the SF-12 health survey in nine countries: results from the IQOLA project. J Clin Epidemiol 51(11):1171–1178. https://doi.org/10.1016/S0895-4356(98)00109-7 CrossRefPubMed

30.

Sanderson M, McNamara KP, Neerings K (2004) Health status in Utah: the medical outocmes study SF-12 (2001) (trans: health UDo). Utah Department of Health, Salt Lake City, UT

31.

Mader LV,J, Christen S, Baenziger J, Roser K, Dehler S, Michel G (2017) Education, employment and marriage in long-term survivors of teenage and young adult cancer compared with healthy controls. Swiss Med Wkly. https://doi.org/10.4414/smw.2017.14419

32.

Kuehni CE, Strippoli M-PF, Rueegg CS, Rebholz CE, Bergstraesser E, Grotzer M, von der Weid NX, Michel G (2012) Educational achievement in Swiss childhood cancer survivors compared with the general population. Cancer 118(5):1439–1449. https://doi.org/10.1002/cncr.26418 CrossRefPubMed

33.

Die Bevölkerung der Schweiz 2015 (2016) Bundesamt für Statistik, Neuchâtel

34.

Steliarova-Foucher E, Stiller C, Lacour B, Kaatsch P (2005) International classification of childhood cancer, third edition. Cancer 103(7):1457–1467CrossRefPubMed

35.

Siegel RL, Miller KD, Jemal A (2016) Cancer statistics, 2016. CA Cancer J Clin 66(1):7–30. https://doi.org/10.3322/caac.21332 CrossRefPubMed

36.

Bellizzi KM, Smith AW, Reeve BB, Alfano CM, Bernstein L, Meeske K, Baumgartner KB, Ballard-Barbash RR (2010) Posttraumatic growth and health-related quality of life in a racially diverse cohort of breast cancer survivors. J Health Psychol 15(4):615–626. https://doi.org/10.1177/1359105309356364 CrossRefPubMed

37.

Bachmann NB,L, Kohler D (2015) Gesundheit in der Schweiz - Fokus chronische Erkrankungen. Nationaler Gesundheitsbericht 2015, Bern

38.

Harzing A-W (2006) Response styles in cross-national survey research. Int J Cross Cult Manag 6(2):243–266. https://doi.org/10.1177/1470595806066332 CrossRef

39.

Schulz M, Wirtschaftsforschung DIf (2012) Messartefakte bei der Erfassung der Gesundheit von Migranten in Deutschland: zur interkulturellen Äquivalenz des SF-12-Fragebogen im Sozio-oekonomischen Panel (SOEP). SOEPpapers on Multidisciplinary Panel Data Research at DIW Berlin; 447. DIW Berlin, Berlin

40.

Smith AW, Bellizzi KM, Keegan TH, Zebrack B, Chen VW, Neale AV, Hamilton AS, Shnorhavorian M, Lynch CF (2013) Health-related quality of life of adolescent and young adult patients with cancer in the United States: the adolescent and young adult health outcomes and patient experience study. J Clin Oncol 31(17):2136–2145. https://doi.org/10.1200/JCO.2012.47.3173 CrossRefPubMedPubMedCentral

41.

Lätsch D, Pfiffner, R., Wild-Näf, M (2011) Die Gesundheit sozialhilfebeziehender Erwerbsloser in der Stadt Bern. Schlussbericht zuhanden des Auftraggebers

Title: Health-related quality of life in adolescent and young adult cancer survivors
Authors: Erika Harju
Katharina Roser
Silvia Dehler
Gisela Michel
Publication date: 01-09-2018
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 9/2018
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-018-4151-z

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 9/2018

Multidrug-resistant bacterial microorganisms (MDRO) in end-of-life care: development of recommendations for hospitalized patients using a mixed-methods approach

A randomized, open-label non-inferiority study to compare palonosetron and ondansetron for prevention of acute chemotherapy-induced vomiting in children with cancer receiving moderate or high emetogenic chemotherapy

Can early palliative care with anticancer treatment improve overall survival and patient-related outcomes in advanced lung cancer patients? A review of the literature

Addition of doxycycline to ciprofloxacin for infection prophylaxis during autologous stem cell transplants for multiple myeloma

Post-traumatic stress in head and neck cancer survivors and their partners

Patients’ Experience of Living with Cancer-associated thrombosis in Spain (PELICANOS)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer