Adolescent and Young Adult Cancer Survivors

Compared to people who have never had cancer, adolescent and young adult (AYA) cancer survivors (those who were 15 to 29 years old when they were first told they had cancer) are more likely to smoke, less likely to get enough physical activity, and less likely to be able to afford to visit a doctor.

CDC scientists used the 2009 Behavioral Risk Factor Surveillance System (BRFSS) to describe demographic characteristics, risk behaviors, chronic health problems, health status, and health care access among AYA cancer survivors in the United States.

Health Risk Behaviors

Smoking. Cancer survivors who smoke are more likely to get a second cancer and other health problems. This study found that more than one out of every four AYA cancer survivors smokes, which is almost 10% higher than those without cancer. Intensive stop-smoking programs are needed in this high-risk group. Peer counseling has been shown to work.

Binge drinking. Cancer survivors who continue to drink alcohol increase their chances of their cancer coming back and of getting a second cancer. The same proportion of AYA cancer survivors reported binge drinking in this study as people who never had cancer.

Physical activity. Physical activity has been shown to increase survival and lower the chances of cancer coming back among breast and colorectal cancer survivors, but more AYA cancer survivors were obese and reported no leisure-time physical activity in the past month than people who never had cancer. Since cancer survivors may have physical limitations as a result of cancer treatment, they may need physical fitness programs that are tailored to their needs.

Chronic Health Problems

Compared with respondents who have never had cancer, more AYA cancer survivors had heart disease (14% vs. 7%), high blood pressure (35% vs. 29%), disability (36% vs. 18%), asthma (15% vs. 8%), and diabetes (12% vs. 9%). Most of these conditions may be long-term effects of being treated for cancer as a young child.

Access to Health Care

Although the same proportion of AYA cancer survivors and people who never had cancer had health insurance, more AYA cancer survivors (24%) couldn’t afford to visit a doctor than people who never had cancer (15%). This may be due to high medical costs related to long-term side effects of treatment, as well as being more likely to be unemployed or unable to work. About 24% of AYA cancer survivors were out of work or unable to work compared to 14% of people who never had cancer. There was no difference in having health insurance, a personal health care provider, or a checkup in the past two years.

Health-Related Quality of Life

Compared with respondents who have never had cancer, more AYA cancer survivors reported 14 or more days of poor mental health in the past month (20% vs. 10%), and 14 or more days of poor physical health in the past month (24% vs. 10%).

Conclusions

AYA cancer survivors need to know more about the long-term risks of unhealthy behaviors and chronic health problems, and get follow-up care for the rest of their lives. In addition, programs for health care providers explaining the need for continued follow-up care for AYA cancer survivors are needed. Health care providers need to be aware of established follow-up guidelines, which include information on potential late effects, risk factors, screening and evaluation, counseling, and other interventions.

Citation

Tai E, Buchanan N, Townsend J, Fairley T, Moore A, Richardson LC. Health status of adolescent and young adult cancer survivors. Cancer 2012;118(19):4884–4891.