Our study targets a significantly understudied research question in adolescent and young adult (AYA) cancer survivorship: How does a cancer diagnosis during adolescence and young adulthood affect survivors'quality of life? Due to the unique developmental transitions that occur for AYAs, such as completing education, starting careers, and gaining financial independence, a cancer diagnosis may cause particular burden for this age group. Guided by a conceptual model of cancer survivor quality of life, we will use the 2009 Behavioral Risk Factor Surveillance System (BRFSS) data to evaluate quality of life for survivors of AYA cancer in response to this PAR 12-035's identification of large, national datasets for assessing cancer prevention and control outcomes.
In Specific Aim 1, we will evaluate the quality of life of survivors of AYA cancer (diagnosed ages 15- 39) compared to similarly-aged individuals without cancer.
In Specific Aim 2, we will investigate whether survivors of AYA cancer are at higher risk for comorbid conditions, poor health behavior, and educational and employment limitations compared to similarly-aged individuals without cancer. We identified these outcomes (referred to as """"""""Survivorship Factors"""""""") as fundamentally important to quality of life due to the unique developmental circumstances of AYAs. Following these analyses, in Specific Aim 3, we will determine whether quality of life is associated with the Survivorship Factors of interest, to provide information on the factors that most influence poor quality of life among AYA survivors. For all aims, we will examine our outcomes by age at diagnosis (e.g., 15-20, 21-29, 30-39), current age (e.g., 18-29;30-39;40-49;50-64;e65) and sex to capture unique sub-group differences. We will determine whether survivors of minority race or ethnicity are at particular risk for poor quality of life. Our study is the first to estimate the nation-wide impactof cancer on AYA survivor quality of life with a control group comparison. To date, the majority of studies on AYA survivors have been limited to specific cancer diagnoses and to samples drawn from a limited number of cancer registries or clinics that do not include a comparison group. Following this R03 study, our team will apply for an R21 grant to support a subsequent mixed methods study. We will perform qualitative interviews to inform a survey to launch a comprehensive evaluation of AYA cancer survivor quality of life that considers important differences in cancer stage and treatment intensity. This R03 is a fundamental step towards meeting our long-term goal of creating interventions tailored to the unique comorbidity, health behavior, educational and employment needs of AYA survivors to improve their quality of life.

Public Health Relevance

Nearly 70,000 adolescent and young adult (AYA) cancers are diagnosed each year in the United States;however, to date, cancer survivorship research has overwhelmingly focused on younger or older cancer populations. Using a population-based dataset, we will investigate how cancer diagnosed during adolescence and young adulthood affects the quality of life for these survivors, and how comorbidities, poor health behaviors and problems with education/employment may place AYA survivors at risk for quality of life limitations. This proposed study is an important step towards developing intervention programs to improve outcomes for AYA cancer survivors.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Small Research Grants (R03)
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Special Emphasis Panel (ZCA1-SRLB-Y (J1))
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Demoor, Janet S
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University of Utah
Schools of Medicine
Salt Lake City
United States
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Warner, Echo L; Nam, Gina E; Zhang, Yingying et al. (2016) Health behaviors, quality of life, and psychosocial health among survivors of adolescent and young adult cancers. J Cancer Surviv 10:280-90