ASPO Abstracts
Impact of COVID-19 on a nationally representative sample of adolescent and young adult cancer survivors
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2022
Abstract Body:
Purpose of the study: To describe experiences of adolescent and young adult cancer survivors (AYAs) during the COVID-19 pandemic in a nationally representative sample.Methods: We identified 71 AYAs (age 18-39 years) with a cancer history and 284 age- and sex-matched non-cancer controls from the population-based National Health Interview Survey (NHIS); the 2020 NHIS survey included questions related to the COVID-19 pandemic. We estimated the proportion of AYAs and non-cancer controls reporting disruptions in health care due to the pandemic and changes in social support, as well as employment, material hardship, mental health issues, and health behaviors. We compared differences in proportions using Chi-square tests.Results: AYAs were predominantly non-Hispanic White (62.8%) and female (60.2%), with a median age at diagnosis of 28 years (IQR 21-32 years). The most common cancers were gynecologic (27.5%), melanoma or other skin cancers (23.3%), and thyroid cancers (16.1%). AYAs had a higher prevalence of chronic conditions related to COVID-19 severity than non-cancer controls, including asthma (24.2% vs. 8.2%) and diabetes (9.4% vs. 0.9%). A third of AYAs (32.5%) had two or more chronic conditions, and about 10% were immunocompromised. A higher proportion of AYAs delayed care (37.0% vs. 16.1%) or did not get needed care (29.5% vs. 11.8%) because of the COVID-19 pandemic, compared to non-cancer controls (p<0.01). AYAs also experienced greater loss of social and emotional support during the pandemic than non-cancer controls (21.6% vs. 10.8%, p=0.03). Fewer AYAs were employed (58.2% vs. 74.7%, p=0.07), and more than double lived in poverty (30.5 vs. 13.2%, p<0.01) and reported problems paying medical bills (25.1% vs. 12.0% p=0.03). A higher proportion of AYAs experienced sleep problems (32.2% vs. 19.2%, p=0.03) and daily feelings of depression (8.9% vs. 2.5%, p=0.02) compared to non-cancer controls. A similar proportion of AYAs and non-cancer controls regularly drank alcohol.Conclusions: The COVID-19 pandemic disrupted care for AYAs and exacerbated the unique challenges and unmet needs of this population. Providers and health systems should ensure that AYAs are reconnected to both medical and psychosocial services and provide age-appropriate, comprehensive care.
Keywords: adolescent and young adult cancer; cancer survivorship; COVID-19